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[The importance of adrenal vein sampling in primary aldosteronism. Necessary examination for many patients as computed tomography can lead to errors].

Primary aldosteronism is the cause of hypertension in 5-10% of the hypertensive population. Almost half of all patients with primary aldosteronism have unilateral disease, i.e. the dominating aldosterone production derives from one of the adrenal glands, and the rest have bilateral disease. The treatment of choice for patients with unilateral disease is unilateral laparoscopic/retroperitoneoscopic adrenalectomy. One-third of patients with unilateral disease have normal adrenal glands on imaging studies or changes in both of the adrenal glands. Similarly, 30% of patients with bilateral excessive aldosterone production have radiological evidence of adenoma in only one of the adrenal glands. Adrenal vein sampling should be considered mandatory in patients with primary aldosteronism prior to surgical treatment.