Endocrine Abstracts

Objectives: This study aimed to assess the ability of aldosterone in saline infusion test (SIT) to predict biochemical remission of primary aldosteronism.

Methods: We retrospectively analysed 42 patients (19 (45%) females, mean age 49±12 years) with primary aldosteronism who underwent adrenalectomy (after adrenal vein sampling confirmation of unilateral disease) from 2017 to 2022. Aldosterone in SIT was determined on the fifth postoperative day, as well as 6-12 months after surgery, together with the aldosterone-to-renin ratio (ARR). Biochemical remission (complete, partial, or absent) of primary aldosteronism was defined according to the Primary Aldosteronism Surgical Outcomes (PASO) criteria.

Results: On the fifth postoperative day, 28 (66.7%) patients (group 1) had aldosterone in SIT <139 pmol/l, indicating complete biochemical remission; in 11 (26.2%) patients (group 2), aldosterone concentration in SIT was between 139 and 277 pmol/l which is consistent with partial biochemical remission; and 3 (7.1%) patients (group 3) had aldosterone in SIT >277 pmol/l, implicating absent biochemical remission. However, at the follow-up after 6-12 months, in four patients from group 1 ARR and aldosterone in SIT were consistent with partial biochemical remission. Similarly, in nine patients from group 2, and in two patients from group 3, ARR suggested complete biochemical remission. There was no statistically significant difference between these groups (P=0.646). Overall, 35 (83.3%) patients in our sample achieved complete biochemical remission, while 7 (16.7%) patients achieved partial biochemical remission.

Conclusions: Our results suggest that early postoperative aldosterone in SIT does not predict biochemical remission of primary aldosteronism.