Fludrocortisone suppression test in normal subjects, in patients with essential hypertension and in patients with various forms of aldosteronism.
The response of urinary diurnal tetrahydroaldosterone (TH-aldo) excretion for fluodrocortisone administration (0.3 mg q.i.d. for 3 days) was studied. In normal subjects (n = 13) and in patients with essential hypertension (n = 8), urinary TH-aldo decreased to 36 per cent (range 19-48) and to 51 per cent (range 33-61) of the control value, respectively. Twenty-four patients with primary aldosteronism were studied. Twenty-two of these showed no significant suppression of urinary TH-aldo in that the excretion of TH-aldo was 79 per cent of the control value or more. Nineteen of these patients were submitted to operation, and an adrenal aldosterone-producing adenoma was disclosed in every single case. Two patients with primary aldosteronism demonstrated a significant suppression of aldosterone production to 62 and 68 per cent, respectively. Adrenal micronodular hyperplasia was verified in one case and suspected in the other. A significant suppression of aldosterone production was observed in 4 of 5 patients with aldosteronism and normal or high plasma renin levels. The combination of low plasma renin and autonomy of aldosterone production offers a high degree of certainty for the presence of an aldosterone-producing adenoma.
D000236:Adenoma / Q000378:metabolism; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000378:metabolism; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000031:analogs & derivatives* / Q000652:urine; D001794:Blood Pressure; D002648:Child; D003404:Creatinine / Q000652:urine; D004573:Electrolytes / Q000097:blood; D005260:Female; D005438:Fludrocortisone; D006801:Humans; D006929:Hyperaldosteronism / Q000652:urine*; D006965:Hyperplasia; D006973:Hypertension / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood; D013577:Syndrome
D004573:Electrolytes; D000450:Aldosterone; D003404:Creatinine; D012083:Renin; D005438:Fludrocortisone