{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:45:24Z","timestamp":1782409524019,"version":"3.54.5"},"reference-count":45,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Sao Paulo Research Foundation","doi-asserted-by":"publisher","award":["2019\/15873-6"],"award-info":[{"award-number":["2019\/15873-6"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Confirmatory tests represent a fundamental step in primary aldosteronism (PA) diagnosis, but they are laborious and often require a hospital environment due to the risks involved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the efficacy of oral furosemide as a new confirmatory test for PA diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We prospectively evaluated the diagnostic performance of 80\u2005mg of oral furosemide in 64 patients with PA and 22 with primary hypertension (controls). Direct renin concentration (DRC) was measured before, and 2\u2005hours and 3\u2005hours after the oral furosemide. In addition, the oral furosemide test was compared with 2 other confirmatory tests: the furosemide upright test (FUT) and saline infusion test (SIT) or captopril challenge test (CCT) in all patients with PA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The cut-off of 7.6\u2005\u00b5U\/mL for DRC at 2\u2005hours after oral furosemide had a sensitivity of 92%, specificity of 82%, and accuracy of 90% for PA diagnosis. In 5 out of 6 controls with low-renin hypertension, which might represent a PA spectrum, renin remained suppressed. Excluding these 6 controls with low-renin hypertension, the DRC cut-off of 10\u2005\u00b5U\/mL at 2\u2005hours after oral furosemide had a sensitivity of 95.3%, specificity of 93.7% and accuracy of 95% for PA diagnosis. DRC after 3\u2005hours of oral furosemide did not improve diagnostic performance. Using the cut-off of 10\u2005\u00b5U\/mL, the oral furosemide test and the FUT were concordant in 62 out of 64 (97%) patients with PA. Only 4 out of 64 cases with PA (6.4%) ended the oral furosemide test with potassium &amp;lt;3.5\u2005mEq\/L. Hypotension was not evidenced in any patient with PA during the test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The oral furosemide test was safe, well-tolerated and represents an effective strategy for PA investigation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvad147","type":"journal-article","created":{"date-parts":[[2023,11,25]],"date-time":"2023-11-25T03:53:17Z","timestamp":1700884397000},"source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of Oral Furosemide Test for Primary Aldosteronism Diagnosis"],"prefix":"10.1210","volume":"8","author":[{"given":"Thais C","family":"Freitas","sequence":"first","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Alice W","family":"Maciel","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo F C","family":"Fagundes","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaina","family":"Petenuci","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas S","family":"Santana","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto G","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Freitas-Castro","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-3833","authenticated-orcid":false,"given":"Victor","family":"Srougi","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Y","family":"Tanno","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L","family":"Chambo","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Adelaide A","family":"Pereira","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana P","family":"Brito","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pio-Abreu","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Disciplina de Nefrologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz A","family":"Bortolotto","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Faculdade de Medicna da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-900 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Claudia","family":"Latronico","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2557-1355","authenticated-orcid":false,"given":"Maria Candida B V","family":"Fragoso","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM\/42, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"},{"name":"Divis\u00e3o de Oncologia End\u00f3crina, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo (ICESP), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 01246-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano F","family":"Drager","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Disciplina de Nefrologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"},{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Faculdade de Medicna da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-900 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berenice B","family":"Mendonca","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM\/42, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2957-6148","authenticated-orcid":false,"given":"Madson Q","family":"Almeida","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM\/25, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 05403-000 , Brazil"},{"name":"Divis\u00e3o de Oncologia End\u00f3crina, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo (ICESP), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, 01246-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"issue":"5","key":"2024010416105335100_bvad147-B1","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 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Coll Cardiol"},{"issue":"9","key":"2024010416105335100_bvad147-B5","doi-asserted-by":"crossref","first-page":"3266","DOI":"10.1210\/jc.2008-0104","article-title":"Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline","volume":"93","author":"Funder","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2024010416105335100_bvad147-B6","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1530\/EJE-18-0704","article-title":"MANAGEMENT OF ENDOCRINE DISEASE: the role of confirmatory tests in the diagnosis of primary aldosteronism","volume":"180","author":"Morera","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"10","key":"2024010416105335100_bvad147-B7","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1097\/HJH.0000000000002510","article-title":"Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working 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