The diagnosis and treatment of primary hyperaldosteronism in Germany: results on 555 patients from the German Conn Registry.
BACKGROUND
Primary hyperaldosteronism (Conn's syndrome) is being diagnosed increasingly often. As many as 12% of patients with hypertension have the characteristic laboratory constellation of Conn's syndrome. Its diagnosis and treatment have not been standardized.


METHODS
The authors retrospectively analyzed data of 555 patients (327 men and 228 women, aged 55 +/- 13 years) who were treated for primary hyperaldosteronism in 5 different centers from 1990 to 2006. The objective was to determine center-specific features of diagnosis and treatment.


RESULTS
353 (63%) of the patients had the hypokalemic variant of primary hyperaldosteronism; 202 never had documented hypokalemia. The centers differed markedly with respect to the patients' clinical presentation, diagnostic testing of endocrine function, and diagnostic imaging techniques, including adrenal venous sampling. The adrenalectomy rate ranged from 15% to 46%.


CONCLUSIONS
The registry data reveal an unexpected heterogeneity in the diagnostic evaluation and treatment of primary hyperaldosteronism. National or international guidelines are needed so that these can be standardized.
Schirpenbach
Caroline
C
Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Germany.
Segmiller
Felix
F
Diederich
Sven
S
Hahner
Stefanie
S
Lorenz
Reinhard
R
Rump
Lars C
LC
Seufert
Jochen
J
Quinkler
Marcus
M
Bidlingmaier
Martin
M
Beuschlein
Felix
F
Endres
Stephan
S
Reincke
Martin
M
D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors