Diagnosis of an Aldosterone-Producing Adenoma in Primary Aldosteronism: An Evaluative Maneuver

Increased aldosterone production in a hypertensive patient, although infrequent, suggests the possible presence of an aldosterone-producing adenoma (APA). The usefulness of the desoxycorticosterone acetate test is that it provides presumptive evidence that an APA is the cause of the hyperaldosterone state. With a high sodium intake, desoxycorticosterone acetate is administered for three days and aldosterone excretion is measured just before and on the third day. Failure to reduce urinary aldosterone levels into the normal range or to depress normal levels is significant evidence of an APA and for surgical exploration.