Big data-benadering voor aldosteron-renineratio bij primair hyperaldosteronisme

BACKGROUND:Prior retrospective studies of aldosterone-renin ratio (ARR) measures were confounded by selection bias.METHODS:To define ARR sensitivity independent of case definition, administrative health and diagnostic imaging repositories in Alberta, Canada, were used to construct a 5-component definition for primary aldosteronism (PA) for the most easily recognizable cases. Components included hypertension, hypokalemia, adrenal mass, suppressed renin, and nonsuppressed aldosterone. ARR was omitted from the definition, permitting independent evaluation of the ARR using receiver operating characteristic curve analysis. The definition was validated by adrenal vein sampling and surgical outcomes.RESULTS:Of 931 adrenal vein sampling patients, 19.2% met the 5-component PA case definition; of these, 86.8% had unilateral disease, and of the 76.8% who underwent surgery, 91.2% achieved complete biochemical response. Between 2012 and 2019, 6717 patients with hypertension had ARR measured; 60.9%