endocrine and metabolic disorders
Secondary Aldosteronism
Diagnosis of Secondary Aldosteronism
Serum electrolyte levels Plasma aldosterone Plasma renin activity (PRA) Diagnosis is suspected in patients with hypertension and hypokalemia. Initial laboratory testing consists of plasma aldosterone levels and plasma renin activity (PRA). Ideally, the patient should not take any drugs that affect the renin-angiotensin system (eg, thiazide diuretics, angiotensin-converting enzyme [ACE] inhibitors, angiotensin antagonists, beta-blockers) for 4 to 6 weeks before tests are done. Elevated aldosterone and plasma renin activity is indicative of secondary aldosteronism. The principal differences between primary and secondary aldosteronism are shown in the table. 