My aldosterone to renin ratio is 33.3. How likely is this to be primary hyperaldosteronism?

Question

Hello doctor,

I have fluid retention and high blood pressure which caused me multiple strokes and TIAs. My plasma renin activity is 0.12 and my aldosterone-to-renin ratio is 33.3, which qualifies clinically as primary hyperaldosteronism. My aldosterone LC/MS is 4. My potassium level 4.0. CT scan of my abdomen did not show my adrenal glands. How likely is it that I have primary hyperaldosteronism? I am currently taking Crestor 20 mg, Amlodipine 10 mg, and Aspirin 325 mg.

Answer 1

Hello,

Welcome to icliniq.com.

I just read your query and from what you have mentioned it appears that you do have primary hyperaldosteronism and it is a very high likelihood for it to be a possibility based on your results. You can try MRI (magnetic resonance imaging) scan for proper visualization of your abdomen.

I hope this helps.

Answer 2

Hi,

Welcome back to icliniq.com.

Adrenal vein sampling has its best use when the adrenal imaging is normal despite biochemical evidence for primary aldosteronism. Also, you need to do suppression testing with measurement of aldosterone response to fludrocortisone or to salt loading. This is for definitive confirmation of diagnosis. There is also a need for genetic testing for the hybrid gene causing familial hyperaldosteronism type 1 (glucocorticoid remediable aldosteronism). These suppression tests are hospital-based meaning requires hospital admission. Well, the entire adrenal gland needs to removed and not just the tumor. The gland itself is very small. It also depends upon the endocrine surgeon's point of view.

I hope this helps.