{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:32:28Z","timestamp":1791304348034,"version":"4.3.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,6,26]],"date-time":"2018-06-26T00:00:00Z","timestamp":1529971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The saline suppression test (<jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content>) serves to confirm the diagnosis of primary aldosteronism (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>) whilst adrenal vein sampling (<jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content>) is used to determine whether the aldosterone hypersecretion is unilateral or bilateral. An accurate prediction of bilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> based on <jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content> results could reduce the need for <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We sought to identify <jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content> parameters that reliably predict bilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The results from 121 patients undergoing <jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content>s at Monash Health from January 2010 to January 2018 including screening blood tests, imaging, <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> and histopathology results were evaluated. Patients were subtyped into unilateral or bilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> based on <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> and surgical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 113 patients with confirmed <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>, 33 had unilateral disease whilst 42 had bilateral disease. In those with bilateral disease, plasma aldosterone concentration (<jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>) was significantly lower post\u2010<jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content>, together with a significant fall in the aldosterone\u2010renin ratio (<jats:styled-content style=\"fixed-case\">ARR<\/jats:styled-content>). The combination of <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u00a0&lt;\u00a0300\u00a0pmol\/L and a reduction in <jats:styled-content style=\"fixed-case\">ARR<\/jats:styled-content> post\u2010<jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content> provided 96.8% specificity in predicting bilateral disease. Eighteen of 39 patients (49%) with bilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> could have avoided <jats:styled-content style=\"fixed-case\">AVS<\/jats:styled-content> using these criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A combination of <jats:styled-content style=\"fixed-case\">PAC<\/jats:styled-content>\u00a0&lt;\u00a0300\u00a0pmol\/L and a lower <jats:styled-content style=\"fixed-case\">ARR<\/jats:styled-content> post\u2010<jats:styled-content style=\"fixed-case\">SST<\/jats:styled-content> could reliably predict bilateral <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. An independent cohort will be needed to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13757","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T13:32:18Z","timestamp":1528291938000},"page":"308-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Saline suppression test parameters may predict bilateral subtypes of primary aldosteronism"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6994-8014","authenticated-orcid":false,"given":"Hikaru","family":"Hashimura","sequence":"first","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Vic. Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Vic. Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9598-4908","authenticated-orcid":false,"given":"Nicholas Y. N.","family":"Chee","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C. G.","family":"Doery","sequence":"additional","affiliation":[{"name":"Department of Pathology Monash Health  Clayton Vic. Australia"},{"name":"Department of Medicine Monash University  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winston","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Imaging Monash Health  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay Weng","family":"Choy","sequence":"additional","affiliation":[{"name":"Department of Pathology Monash Health  Clayton Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"StellaMay","family":"Gwini","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventative Medicine Monash University  Clayton Vic. Australia"},{"name":"University Hospital Geelong \u2010 Barwon Health  Geelong Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":false,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Vic. Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Vic. 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