ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Prevalence and significance of hypokalemia in primary aldosteronism: a retrospective study
Siddiqa Soomauroo 1 , Faten Hadjkacem 1 , Abdelmuhaymen Missaoui 1 , Ahmad Ridwaan Auckburally 2 , Souhir Maalej 1 , Wiem Feki 2 , Zeinab Mnif 2 , Mouna Mnif 1 , Mohamed Abid 1 & Nabila Rekik 1
1Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia; 2Hedi Chaker University Hospital, Department of Radiology, Sfax, Tunisia
Introduction: Primary hyperaldosteronism (PA) is the autonomous production of aldosterone by a disease primarily affecting the glomerular zone of the adrenal gland. It is one of the most frequent causes of secondary hypertension. The diagnosis should be suspected in the presence of the classic clinico-biological triad in patients presenting with hypertension, low plasma renin activity (PRA), with or without hypokalemia.
Patients and Methods: Retrospective and descriptive study concerning 40 patients with PA, collected in the endocrinology department of the Hedi Chaker University Hospital of Sfax, over the period of 10 years from January 2010 to December 2022.
Results: The average age of our patients was 55.4 years. They were composed of 16 men and 24 women. In 32% of cases, hypertension was recent, evolving for less than than 5 years. Severe hypertension was found in 11 cases. Hypokalemia was noted in 19 cases (47.5%), symptomatic of asthenia in the majority of cases (60%). Analytical study of the correlation between serum potassium levels and plasma aldosterone concentration (PAC) showed that 15 of these patients had PAC above 200 pg/ml. As PAC increased, so did the number of patients with hypokalemia, with a correlation coefficient r=-0.350, P=0.027. The threshold of the PAC was studied by the ROC curve. A PAC level above 199 pg/ml was predictive of hypokalemia with a sensitivity of 78.9% and specificity of 66.7%. Following specific treatment of the PA (surgery or spironolactone), a significant increase in mean kalemia was observed during patient follow-up (P<0.001) compared with kalemia on admission.
Conclusion: Contrary to initial data, normokalemic rather than hypokalemic PA is the most frequent form of hyperaldosteronism. Hypokalemia is neither a sensitive nor a specific marker for the diagnosis of PA. Nevertheless, its presence can help to identify a severe form of the disease, and therefore recognise patients at particularly high cardiovascular risk.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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