{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:39:02Z","timestamp":1787503142978,"version":"build-2736575974"},"reference-count":25,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100009619","name":"AMED","doi-asserted-by":"publisher","award":["JP17ek0109112"],"award-info":[{"award-number":["JP17ek0109112"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"AMED","doi-asserted-by":"publisher","award":["JP19ek0109352"],"award-info":[{"award-number":["JP19ek0109352"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["27\u20131402, 30\u20131008"],"award-info":[{"award-number":["27\u20131402, 30\u20131008"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Previous studies have proposed cutoff value of baseline plasma aldosterone concentration (bPAC) under renin suppression that could diagnose primary aldosteronism (PA) without confirmatory testing. However, those studies are limited by selection bias due to a small number of patients and a single-center study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to determine cutoff value of bPAC and baseline plasma renin activity (bPRA) for predicting positive results in confirmatory tests for PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The multi-institutional, retrospective, cohort study was conducted using the PA registry in Japan (JPAS\/JRAS). We compared bPAC in patients with PA who showed positive and negative captopril challenge test (CCT) or saline infusion test (SIT) results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Patients with PA who underwent CCT (n = 2256) and\/or SIT (n = 1184) were studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The main outcomes were cutoff value of bPAC (ng\/dL) and bPRA (ng\/mL\/h) for predicting positive CCT and\/or SIT results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In patients with renin suppression (bPRA \u2264 0.3), the cutoff value of bPAC that would give 100% specificity for predicting a positive SIT result was lower than that for predicting a positive CCT result (30.85 vs 56.35, respectively). Specificities of bPAC cutoff values \u2265 30.85 for predicting positive SIT and CCT results remained high (100.0% and 97.0%, respectively) in patients with bPRA \u2264 0.6. However, the specificities of bPAC cutoff values \u2265 30.85 for predicting positive SIT and CCT results decreased when patients with bPRA &amp;gt; 0.6 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Confirmatory testing could be omitted in patients with bPAC \u2265 30.85 in the presence of bPRA \u2264 0.6.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa117","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T22:27:54Z","timestamp":1583879274000},"page":"e1990-e1998","source":"Crossref","is-referenced-by-count":13,"title":["Baseline Plasma Aldosterone Level and Renin Activity Allowing Omission of Confirmatory Testing in Primary Aldosteronism"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2754-4182","authenticated-orcid":false,"given":"Junji","family":"Kawashima","sequence":"first","affiliation":[{"name":"Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhide","family":"Naruse","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"},{"name":"Endocrine Center, Takeda General Hospital, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Showa General Hospital, Tokyo, Japan"},{"name":"Department of Nephrology and Endocrinology, University of Tokyo School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0660-5372","authenticated-orcid":false,"given":"Kouichi","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Okamura","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tenri Hospital, Tenri, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shozo","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Uwajima City Hospital, Uwajima, Japan"},{"name":"Department of Diabetes and Endocrinology, Ehime Prefectural Central Hospital, Matsuyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Izawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Tottori University Hospital, Yonago, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyo","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"issue":"1","key":"2021122104154034600_CIT0001","first-page":"3","article-title":"Presidential address. I. Painting background. II. Primary aldosteronism, a new clinical syndrome","volume":"45","author":"Conn","year":"1955","journal-title":"J Lab Clin Med."},{"issue":"5","key":"2021122104154034600_CIT0002","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab."},{"issue":"9","key":"2021122104154034600_CIT0003","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1507\/endocrj.EJ11-0133","article-title":"Guidelines for the diagnosis and treatment of primary aldosteronism\u2013the Japan Endocrine Society 2009","volume":"58","author":"Nishikawa","year":"2011","journal-title":"Endocr J."},{"issue":"3","key":"2021122104154034600_CIT0004","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.ando.2016.01.007","article-title":"SFE\/SFHTA\/AFCE consensus on primary aldosteronism, part 3: confirmatory testing","volume":"77","author":"Reznik","year":"2016","journal-title":"Ann Endocrinol (Paris)."},{"issue":"9","key":"2021122104154034600_CIT0005","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1097\/HJH.0b013e3283060f0c","article-title":"Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma","volume":"26","author":"Letavernier","year":"2008","journal-title":"J Hypertens."},{"issue":"5","key":"2021122104154034600_CIT0006","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1210\/jc.2011-2504","article-title":"Confirmatory testing in primary aldosteronism","volume":"97","author":"Nanba","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2021122104154034600_CIT0007","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/hr.2014.20","article-title":"The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014)","volume":"37","author":"Shimamoto","year":"2014","journal-title":"Hypertens Res."},{"issue":"6","key":"2021122104154034600_CIT0008","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1053\/j.ajkd.2008.12.034","article-title":"Revised equations for estimated GFR from serum creatinine in Japan","volume":"53","author":"Matsuo","year":"2009","journal-title":"Am J Kidney Dis."},{"issue":"3","key":"2021122104154034600_CIT0009","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1210\/jc.2017-01774","article-title":"Significance of computed tomography and serum potassium in predicting subtype diagnosis of primary aldosteronism","volume":"103","author":"Umakoshi","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021122104154034600_CIT0010","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.surg.2004.06.051","article-title":"Role for adrenal venous sampling in primary aldosteronism","volume":"136","author":"Young","year":"2004","journal-title":"Surgery."},{"issue":"3","key":"2021122104154034600_CIT0011","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1055\/s-0031-1295438","article-title":"Prevalence of primary aldosteronism in patient\u2019s cohorts and in population-based studies\u2013a review of the current literature","volume":"44","author":"Hannemann","year":"2012","journal-title":"Horm Metab Res."},{"issue":"5","key":"2021122104154034600_CIT0012","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1365-2265.2007.02775.x","article-title":"Primary aldosteronism: renaissance of a syndrome","volume":"66","author":"Young","year":"2007","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"5","key":"2021122104154034600_CIT0013","doi-asserted-by":"crossref","first-page":"e005574","DOI":"10.1161\/JAHA.117.005574","article-title":"Quantitative value of aldosterone-renin ratio for detection of aldosterone-producing adenoma: the aldosterone-renin ratio for primary aldosteronism (AQUARR) study","volume":"6","author":"Maiolino","year":"2017","journal-title":"J Am Heart Assoc."},{"issue":"3","key":"2021122104154034600_CIT0014","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1055\/a-0857-1620","article-title":"Evaluation of biochemical conditions allowing bypass of confirmatory testing in the workup of primary aldosteronism: a retrospective study in a french hypertensive population","volume":"51","author":"Vivien","year":"2019","journal-title":"Horm Metab Res."},{"key":"2021122104154034600_CIT0015","article-title":"Q-AND-A study group. Role of aldosterone and potassium levels in sparing confirmatory tests in primary aldosteronism","author":"Umakoshi","year":"2019","journal-title":"J Clin Endocrinol Metab."},{"issue":"3","key":"2021122104154034600_CIT0016","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1385\/ENDO:21:3:221","article-title":"A case of normoreninemic aldosterone-producing adenoma associated with chronic renal failure: case report and literature review","volume":"21","author":"Koshiyama","year":"2003","journal-title":"Endocrine."},{"issue":"9","key":"2021122104154034600_CIT0017","doi-asserted-by":"crossref","first-page":"3266","DOI":"10.1210\/jcem.85.9.6819","article-title":"Primary hyperaldosteronism without suppressed renin due to secondary hypertensive kidney damage","volume":"85","author":"Oelkers","year":"2000","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021122104154034600_CIT0018","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1210\/jc.2002-021476","article-title":"Variability in the renin\/aldosterone profile under random and standardized sampling conditions in primary aldosteronism","volume":"88","author":"Tanabe","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"issue":"2","key":"2021122104154034600_CIT0019","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1161\/HYPERTENSIONAHA.107.093468","article-title":"Captopril test can give misleading results in patients with suspect primary aldosteronism","volume":"50","author":"Mulatero","year":"2007","journal-title":"Hypertension."},{"issue":"7","key":"2021122104154034600_CIT0020","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1097\/HJH.0b013e328126856e","article-title":"Prospective evaluation of the saline infusion test for excluding primary aldosteronism due to aldosterone-producing adenoma","volume":"25","author":"Rossi","year":"2007","journal-title":"J Hypertens."},{"issue":"1","key":"2021122104154034600_CIT0021","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1161\/HYPERTENSIONAHA.117.10197","article-title":"Confirmatory tests for the diagnosis of primary aldosteronism: a prospective diagnostic accuracy study","volume":"71","author":"Song","year":"2018","journal-title":"Hypertension."},{"issue":"6","key":"2021122104154034600_CIT0022","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1161\/01.HYP.37.6.1440","article-title":"Captopril suppression versus salt loading in confirming primary aldosteronism","volume":"37","author":"Agharazii","year":"2001","journal-title":"Hypertension."},{"issue":"2","key":"2021122104154034600_CIT0023","doi-asserted-by":"crossref","first-page":"277","DOI":"10.3803\/EnM.2016.31.2.277","article-title":"Diagnostic role of captopril challenge test in korean subjects with high aldosterone-to-renin ratios","volume":"31","author":"Kim","year":"2016","journal-title":"Endocrinol Metab (Seoul)."},{"issue":"11","key":"2021122104154034600_CIT0024","doi-asserted-by":"crossref","first-page":"4113","DOI":"10.1210\/jc.2018-01394","article-title":"Comparison of seated with recumbent saline suppression testing for the diagnosis of primary aldosteronism","volume":"103","author":"Stowasser","year":"2018","journal-title":"J Clin Endocrinol Metab."},{"issue":"9","key":"2021122104154034600_CIT0025","doi-asserted-by":"crossref","first-page":"4292","DOI":"10.1210\/jcem.86.9.7867","article-title":"Performance of the basal aldosterone to renin ratio and of the renin stimulation test by furosemide and upright posture in screening for aldosterone-producing adenoma in low renin hypertensives","volume":"86","author":"Hirohara","year":"2001","journal-title":"J Clin Endocrinol Metab."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa117\/32889942\/dgaa117.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/5\/e1990\/41828954\/jcem_105_5_e1990.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/5\/e1990\/41828954\/jcem_105_5_e1990.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T23:16:48Z","timestamp":1640042208000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/105\/5\/e1990\/5802680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,10]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,3,10]]},"published-print":{"date-parts":[[2020,5,1]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa117","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5]]},"published":{"date-parts":[[2020,3,10]]}}}