{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:40:37Z","timestamp":1791520837077,"version":"4.3.4"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/501100017557","name":"Swiss National Centre of Competence in Research Kidney Control of Homeostasis","doi-asserted-by":"crossref","award":["310030L_182700,51NF40_183774"],"award-info":[{"award-number":["310030L_182700,51NF40_183774"]}],"id":[{"id":"10.13039\/501100017557","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["CRC\/Transregio 205\/1"],"award-info":[{"award-number":["CRC\/Transregio 205\/1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100008481","name":"Kurt und Senta Herrmann Stiftung","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008481","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"crossref","award":["633983"],"award-info":[{"award-number":["633983"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hypokalemia plays an important role in the diagnosis and management of primary\n                    aldosteronism (PA). While the hypokalemic variant of the disease accounts for\n                    about one third of all cases, little is known about the incidence of PA in\n                    hypokalemic populations. The IPAHK+ study is an epidemiological,\n                    cross-sectional trial to provide evidence on the incidence of PA in hypokalemic\n                    patients from a university hospital outpatient population. Recruitment of\n                    outpatients with hypokalemia\u22643\u2009mmol\/l is carried out on\n                    a continuous referral-basis through an automated data delivery system. Up to an\n                    interim data closure, 66 patients underwent the study protocol. The mean age of\n                    the participants was 52.9\u00b11.5 years with an equal sex ratio of 1:1 women\n                    to men, a mean potassium value of 2.78\u00b10.31\u2009mmol\/l\n                    [1.8;3.0] and a prevalence of arterial hypertension of 72.7%. PA was\n                    diagnosed in 46.6% of all participants, all of whom had a history of\n                    hypertension. Incidence of PA increased continuously with decreasing potassium\n                    levels with proportions of 26.7%, 50% and 57.1% in the\n                    subgroups of 3.0\u2009mmol\/l (n=15),\n                    2.8\u20132.9\u2009mmol\/l (n=22)\n                    and\u22642.7\u2009mmol\/l (n=21), respectively. Prior to\n                    testing, 59.1% of all patients presented at least with one plausible\n                    other cause of hypokalemia. The incidence of PA in the investigated outpatient\n                    population was more than 4 out of 10 and inversely correlated with baseline\n                    potassium levels. Moderate or severe hypokalemia, regardless of its cause,\n                    should therefore prompt evaluation for PA in hypertensive individuals.\n                    Normotensive hypokalemic PA was not observed in this cohort.<\/jats:p>","DOI":"10.1055\/a-2204-3163","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T23:35:46Z","timestamp":1699140946000},"page":"300-307","source":"Crossref","is-referenced-by-count":4,"title":["Unawareness of Primary Aldosteronism as a Common Cause of Hypokalemia\n                    \u2013 Insights from the IPAHK+ Trial (Incidence of\n                    Primary Aldosteronism in Patients with Hypokalemia)"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0601-4334","authenticated-orcid":false,"given":"Sven","family":"Gruber","sequence":"first","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Stasi","sequence":"first","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Boan","family":"Pion","sequence":"additional","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regula","family":"Steiner","sequence":"additional","affiliation":[{"name":"Institute for Clinical Chemistry, University Hospital Zurich, Zurich,\n                    Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Erlic","sequence":"additional","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan R.","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"},{"name":"Department of Medicine, Carl Gustav Carus, University of Dresden,\n                    Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Sudano","sequence":"additional","affiliation":[{"name":"University Heart Center, Cardiology, University Hospital Zurich,\n                    Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Medizinische Klinik Innenstadt, Klinikum der Universit\u00e4t\n                    M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Department for Endocrinology, Diabetology and Clinical Nutrition,\n                    University Hospital Zurich, Zurich, Switzerland"},{"name":"Medizinische Klinik Innenstadt, Klinikum der Universit\u00e4t\n                    M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/joim.12831","article-title":"Diagnosis and treatment of primary aldosteronism: practical clinical\n                    perspectives","volume":"285","author":"W F Young","year":"2019","journal-title":"J Intern Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1530\/EJE-11-1013","article-title":"Screening for primary aldosteronism in hypertensive subjects: results from two\n                    German epidemiological studies","volume":"167","author":"A Hannemann","year":"2012","journal-title":"Eur J Endocrinol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and\n                    treatment: an endocrine society clinical practice guideline","volume":"101","author":"J W Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"e15985","DOI":"10.1097\/MD.0000000000015985","article-title":"Cardiovascular risk in primary aldosteronism: a systematic review and\n                    meta-analysis","volume":"98","author":"X Wu","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S2213-8587(17)30135-3","article-title":"Outcomes after adrenalectomy for unilateral primary aldosteronism: an\n                    international consensus on outcome measures and analysis of remission rates in\n                    an international cohort","volume":"5","author":"T A Williams","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1097\/HJH.0000000000001384","article-title":"Diagnostic rate of primary aldosteronism in Emilia-Romagna, Northern Italy,\n                    during 16 years (2000-2015)","volume":"35","author":"E Rossi","year":"2017","journal-title":"J Hypertens"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1210\/jc.2003-031337","article-title":"Increased diagnosis of primary aldosteronism, including surgically correctable\n                    forms, in centers from five continents","volume":"89","author":"P Mulatero","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1055\/a-1685-0583","article-title":"Incidence of primary aldosteronism in patients with hypokalemia\n                    (IPAHK+): study design and baseline characteristics","volume":"53","author":"S Gruber","year":"2021","journal-title":"Horm Metab Res"},{"key":"ref9","first-page":"115","article-title":"Aldosterone paradox: differential regulation of ion transport in distal\n                    nephron","volume":"26","author":"J P Arroyo","year":"2011","journal-title":"Physiology (Bethesda)"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1210\/jc.2008-2116","article-title":"Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic\n                    primary aldosteronism: results of the German Conn\u2019s Registry","volume":"94","author":"E Born-Frontsberg","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1204598","DOI":"10.1155\/2018\/1204598","article-title":"Aldosterone and mineralocorticoid receptor system in cardiovascular physiology\n                    and pathophysiology","volume":"2018","author":"A Cannavo","year":"2018","journal-title":"Oxid Med Cell Longev"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1055\/s-0031-1295460","article-title":"Factors affecting the aldosterone\/renin ratio","volume":"44","author":"M Stowasser","year":"2012","journal-title":"Horm Metab Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1016\/j.jacc.2006.07.059","article-title":"A prospective study of the prevalence of primary aldosteronism in 1,125\n                    hypertensive patients","volume":"48","author":"G P Rossi","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"ref14","first-page":"104","article-title":"Short-term mortality risk of serum potassium levels in hypertension: a\n                    retrospective analysis of nationwide registry data","volume":"38","author":"M L Krogager","year":"2017","journal-title":"Eur Heart J"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1055\/a-1134-4980","article-title":"Hypokalemia and the prevalence of primary aldosteronism","volume":"52","author":"S Gruber","year":"2020","journal-title":"Horm Metab Res"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1161\/HYPERTENSIONAHA.121.18118","article-title":"Screening rates for primary aldosteronism among individuals with hypertension\n                    plus hypokalemia: a population-based retrospective cohort study","volume":"79","author":"G L Hundemer","year":"2022","journal-title":"Hypertension"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1161\/HYPERTENSIONAHA.119.14063","article-title":"Prevalence of hypokalemia and primary aldosteronism in 5100 patients referred to\n                    a tertiary hypertension unit","volume":"75","author":"J Burrello","year":"2020","journal-title":"Hypertension"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S2213-8587(17)30319-4","article-title":"Cardiovascular events and target organ damage in primary aldosteronism compared\n                    with essential hypertension: a systematic review and meta-analysis","volume":"6","author":"S Monticone","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1681\/ASN.V1143","article-title":"Effect of potassium intake on blood pressure","volume":"1","author":"G G Krishna","year":"1990","journal-title":"J Am Soc Nephrol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1097\/HJH.0000000000000611","article-title":"Daily potassium intake and sodium-to-potassium ratio in the reduction of blood\n                    pressure: a meta-analysis of randomized controlled trials","volume":"33","author":"A Binia","year":"2015","journal-title":"J Hypertens"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2204-3163.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T12:47:45Z","timestamp":1730810865000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2204-3163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,4]]},"references-count":20,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2024,4,11]]},"published-print":{"date-parts":[[2024,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2204-3163","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"value":"0018-5043","type":"print"},{"value":"1439-4286","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,11,4]]},"published":{"date-parts":[[2023,11,4]]}}}