{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:54Z","timestamp":1789448574098,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To characterize electrolyte and renal-metabolic profiles in primary aldosteronism (PA) compared with essential hypertension (EH), and to examine differences between unilateral\/lateralizing and bilateral PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception through 13 July 2026. Random-effects meta-analyses pooled standardized mean differences (SMD; Hedges' g), supplemented by clinical-unit mean-difference analyses, subgroup analyses, sensitivity analyses, and study-level meta-regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 74 observational studies involving 26,143 participants were included. Compared with hypertensive controls, PA was associated with lower serum potassium (SMD = \u22121.15, 95% CI \u22121.27 to \u22121.02), higher serum sodium (SMD = 0.51, 95% CI 0.38 to 0.63), and lower uric acid (SMD = \u22120.23, 95% CI \u22120.35 to \u22120.12), whereas creatinine, estimated glomerular filtration rate (eGFR), and blood urea nitrogen (BUN) did not differ significantly. Corresponding PA-minus-control mean differences were \u22120.49 mmol\/L for potassium, +1.20 mmol\/L for sodium, and \u221220.7 \u03bcmol\/L for uric acid. Potassium was lower in unilateral\/lateralizing than in bilateral PA (SMD = \u22120.85). The potassium difference versus controls was greater in studies with high plasma aldosterone concentration (PAC) than in those with low PAC (SMD \u22121.44 vs. \u22121.03; p for subgroup difference = 0.010), although continuous PAC meta-regression was not significant. UACR\/ACR and urinary albumin excretion were higher in PA (SMD = 0.49 and 0.73).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>PA shows a persistent electrolyte phenotype and higher albuminuria despite similar cross-sectional filtration markers. These findings support renal assessment with UACR alongside routine filtration measures and reinforce that PA screening should not depend on overt hypokalemia alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , identifier CRD420261286832.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1916237","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:28Z","timestamp":1789446388000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biochemical and renal-metabolic profiles distinguishing primary aldosteronism from essential hypertension: a systematic review and meta-analysis with implications for endocrine hypertension screening"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuan","family":"Zhao","sequence":"first","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiu","family":"Yi","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Ding","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf284","article-title":"Primary aldosteronism: An endocrine society clinical practice guideline","volume":"110","author":"Adler","year":"2025","journal-title":"J Clin Endocrinol 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