Kietsiriroje et al reported a score for identifying a patient with primary aldosteronism. This can help to guide the patient work-up. The authors are from Prince of Songkla University in Thailand and Leeds Teachin Hospital NHS Trust.
Patient selection: age > 15 years of age
Parameters:
(1) age in years
(2) body mass index in kilograms per square meter
(3) diabetes
(4) number of antihypertensive agents
(5) serum sodium in mmol/L
(6) serum potassium in mmol/L
Parameter
Finding
Points
age
30 to 59.9 years
3
< 30 or >= 60
0
BMI
< 25 kg per sq m
1
>= 25 kg per sq m
0
diabetes
no
0
yes
-2
antihypertensive drugs
<= 2
0
>= 3
3
serum sodium
< 141 mmol/L
0
>= 141 mmol/L
2
serum potassium
< 3.5 mmol/L
4
>= 3.5 mmol/L
0
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -2
• maximum score: 13
• A score < 4 has a negative predictive value of 99%.
• A score > 9 is diagnostic in a patient at high risk for primary aldosteronism (plasma aldosterone concentration > 15 ng/dL and plasma renin activity < 1 ng/mL/hr).
Performance:
• The area under the ROC curve is 0.87.
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