Re: research study about value of saline infusion test in diagnosing normokalemic PA

[Guest guest]

WE developed the saline test and have done it in 1000s. Most PAs have a normal K if you read my article. Only advanced cases have low K. Be sure K is being drawn according to our guidelines in files.CE Grim MDOn Feb 17, 2010, at 11:26 AM, smkushka wrote:http://www.eje-online.org/cgi/content/full/154/6/865My aldo/renin ratio is 28.5. Since my K is normal and BP controlled on one med, endo does not believe I might have PA. Endo says ratio 28.5 is just suggestive, not definitive (he looks for ratio of 30). However he ordered me off anti-hypertensives for a month, then will retest aldo/renin ratio; he said when I retest, if it is higher than 30, will proceed with saline infusion test. Article above has results of a study showing that saline infusion test for PA in normokalemia is not recommended. (They did not require patients be off anti-hypertensives.) Dr Grim, do you know this study?The study uses this ratio for diagnosis of PA: aldosterone/renin concentration >21 pg/ml:µU/ml. I don't know how pg/ml:µU/ml compares to my last results:Aldosterone result 37.4 ng/dLNormal ranges age 15 and older:Upright 4.0-31.0 ng/dLSupine 16.0 ng/dL or lessUnspecified 31.0 ng/dL or lessRenin, Plasma result 1.3 ng/mL/hrNormal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hrSupine 0.2-1.6 ng/mL/hr

[Guest guest]

Yes, I did read your article on Evolution of PA. Will take to my endo.

So your experience is that saline infusion testing is fine for normokalemic

people? You had suggested I might have spiro test; would that be better or in

addition to saline?

>

> > http://www.eje-online.org/cgi/content/full/154/6/865

> >

> > My aldo/renin ratio is 28.5. Since my K is normal and BP controlled

> > on one med, endo does not believe I might have PA. Endo says ratio

> > 28.5 is just suggestive, not definitive (he looks for ratio of 30).

> > However he ordered me off anti-hypertensives for a month, then will

> > retest aldo/renin ratio; he said when I retest, if it is higher than

> > 30, will proceed with saline infusion test.

> >

> > Article above has results of a study showing that saline infusion

> > test for PA in normokalemia is not recommended. (They did not

> > require patients be off anti-hypertensives.) Dr Grim, do you know

> > this study?

> >

> > The study uses this ratio for diagnosis of PA: aldosterone/renin

> > concentration >21 pg/ml:µU/ml.

> >

> > I don't know how pg/ml:µU/ml compares to my last results:

> >

> > Aldosterone result 37.4 ng/dL

> >

> > Normal ranges age 15 and older:

> > Upright 4.0-31.0 ng/dL

> > Supine 16.0 ng/dL or less

> > Unspecified 31.0 ng/dL or less

> >

> > Renin, Plasma result 1.3 ng/mL/hr

> >

> > Normal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hr

> > Supine 0.2-1.6 ng/mL/hr

> >

> >

> >

>

[Guest guest]

Well it depends IMHO in how well you do on sprio and DASH.If your Sx, BP and K age good on this then I see no reason to do any other testing. If no and you would have surgery if indicated then one can stop spiro fog say 3 months and do saline as well as the Grim perfect set of tests.CE Grim MDOn Feb 17, 2010, at 12:07 PM, smkushka wrote:Yes, I did read your article on Evolution of PA. Will take to my endo.So your experience is that saline infusion testing is fine for normokalemic people? You had suggested I might have spiro test; would that be better or in addition to saline? > > > http://www.eje-online.org/cgi/content/full/154/6/865> >> > My aldo/renin ratio is 28.5. Since my K is normal and BP controlled > > on one med, endo does not believe I might have PA. Endo says ratio > > 28.5 is just suggestive, not definitive (he looks for ratio of 30). > > However he ordered me off anti-hypertensives for a month, then will > > retest aldo/renin ratio; he said when I retest, if it is higher than > > 30, will proceed with saline infusion test.> >> > Article above has results of a study showing that saline infusion > > test for PA in normokalemia is not recommended. (They did not > > require patients be off anti-hypertensives.) Dr Grim, do you know > > this study?> >> > The study uses this ratio for diagnosis of PA: aldosterone/renin > > concentration >21 pg/ml:µU/ml.> >> > I don't know how pg/ml:µU/ml compares to my last results:> >> > Aldosterone result 37.4 ng/dL> >> > Normal ranges age 15 and older:> > Upright 4.0-31.0 ng/dL> > Supine 16.0 ng/dL or less> > Unspecified 31.0 ng/dL or less> >> > Renin, Plasma result 1.3 ng/mL/hr> >> > Normal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hr> > Supine 0.2-1.6 ng/mL/hr> >> >> >>

[Guest guest]

Well it depends IMHO in how well you do on sprio and DASH.If your Sx, BP and K age good on this then I see no reason to do any other testing. If no and you would have surgery if indicated then one can stop spiro fog say 3 months and do saline as well as the Grim perfect set of tests.CE Grim MDOn Feb 17, 2010, at 12:07 PM, smkushka wrote:Yes, I did read your article on Evolution of PA. Will take to my endo.So your experience is that saline infusion testing is fine for normokalemic people? You had suggested I might have spiro test; would that be better or in addition to saline? > > > http://www.eje-online.org/cgi/content/full/154/6/865> >> > My aldo/renin ratio is 28.5. Since my K is normal and BP controlled > > on one med, endo does not believe I might have PA. Endo says ratio > > 28.5 is just suggestive, not definitive (he looks for ratio of 30). > > However he ordered me off anti-hypertensives for a month, then will > > retest aldo/renin ratio; he said when I retest, if it is higher than > > 30, will proceed with saline infusion test.> >> > Article above has results of a study showing that saline infusion > > test for PA in normokalemia is not recommended. (They did not > > require patients be off anti-hypertensives.) Dr Grim, do you know > > this study?> >> > The study uses this ratio for diagnosis of PA: aldosterone/renin > > concentration >21 pg/ml:µU/ml.> >> > I don't know how pg/ml:µU/ml compares to my last results:> >> > Aldosterone result 37.4 ng/dL> >> > Normal ranges age 15 and older:> > Upright 4.0-31.0 ng/dL> > Supine 16.0 ng/dL or less> > Unspecified 31.0 ng/dL or less> >> > Renin, Plasma result 1.3 ng/mL/hr> >> > Normal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hr> > Supine 0.2-1.6 ng/mL/hr> >> >> >>

[Guest guest]

Does this saline infusion test or salt loading test I've read about make you sick? I can only have about 325 mcg of sodium and then get a myriad of symptoms that make me soooo sick like extreme heart palpitations and chest pressure, SOB, extreme nausea and dizziness,etc. I'm worried these test will make me feel horrible again. Are these absolutely needed for testing for PA?

Re: research study about value of saline infusion test in diagnosing normokalemic PA

WE developed the saline test and have done it in 1000s. Most PAs have a normal K if you read my article. Only advanced cases have low K.

Be sure K is being drawn according to our guidelines in files.

CE Grim MD

On Feb 17, 2010, at 11:26 AM, smkushka wrote:

http://www.eje-online.org/cgi/content/full/154/6/865My aldo/renin ratio is 28.5. Since my K is normal and BP controlled on one med, endo does not believe I might have PA. Endo says ratio 28.5 is just suggestive, not definitive (he looks for ratio of 30). However he ordered me off anti-hypertensives for a month, then will retest aldo/renin ratio; he said when I retest, if it is higher than 30, will proceed with saline infusion test. Article above has results of a study showing that saline infusion test for PA in normokalemia is not recommended. (They did not require patients be off anti-hypertensives.) Dr Grim, do you know this study?The study uses this ratio for diagnosis of PA: aldosterone/renin concentration >21 pg/ml:µU/ml. I don't know how pg/ml:µU/ml compares to my last results:Aldosterone result 37.4 ng/dLNormal ranges age 15 and older:Upright 4.0-31.0 ng/dLSupine 16.0 ng/dL or lessUnspecified 31.0 ng/dL or lessRenin, Plasma result 1.3 ng/mL/hrNormal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hrSupine 0.2-1.6 ng/mL/hr

[Guest guest]

Does this saline infusion test or salt loading test I've read about make you sick? I can only have about 325 mcg of sodium and then get a myriad of symptoms that make me soooo sick like extreme heart palpitations and chest pressure, SOB, extreme nausea and dizziness,etc. I'm worried these test will make me feel horrible again. Are these absolutely needed for testing for PA?

Re: research study about value of saline infusion test in diagnosing normokalemic PA

WE developed the saline test and have done it in 1000s. Most PAs have a normal K if you read my article. Only advanced cases have low K.

Be sure K is being drawn according to our guidelines in files.

CE Grim MD

On Feb 17, 2010, at 11:26 AM, smkushka wrote:

http://www.eje-online.org/cgi/content/full/154/6/865My aldo/renin ratio is 28.5. Since my K is normal and BP controlled on one med, endo does not believe I might have PA. Endo says ratio 28.5 is just suggestive, not definitive (he looks for ratio of 30). However he ordered me off anti-hypertensives for a month, then will retest aldo/renin ratio; he said when I retest, if it is higher than 30, will proceed with saline infusion test. Article above has results of a study showing that saline infusion test for PA in normokalemia is not recommended. (They did not require patients be off anti-hypertensives.) Dr Grim, do you know this study?The study uses this ratio for diagnosis of PA: aldosterone/renin concentration >21 pg/ml:µU/ml. I don't know how pg/ml:µU/ml compares to my last results:Aldosterone result 37.4 ng/dLNormal ranges age 15 and older:Upright 4.0-31.0 ng/dLSupine 16.0 ng/dL or lessUnspecified 31.0 ng/dL or lessRenin, Plasma result 1.3 ng/mL/hrNormal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hrSupine 0.2-1.6 ng/mL/hr

[Guest guest]

No the tests are only needed after drugs and diet have failed to control Sx, BP and K and if MCRB Rx fails.CE Grim MDOn Feb 17, 2010, at 10:14 PM, Stone wrote:Does this saline infusion test or salt loading test I've read about make you sick? I can only have about 325 mcg of sodium and then get a myriad of symptoms that make me soooo sick like extreme heart palpitations and chest pressure, SOB, extreme nausea and dizziness,etc. I'm worried these test will make me feel horrible again. Are these absolutely needed for testing for PA? Re: research study about value of saline infusion test in diagnosing normokalemic PA WE developed the saline test and have done it in 1000s. Most PAs have a normal K if you read my article. Only advanced cases have low K. Be sure K is being drawn according to our guidelines in files.CE Grim MDOn Feb 17, 2010, at 11:26 AM, smkushka wrote:http://www.eje-online.org/cgi/content/full/154/6/865My aldo/renin ratio is 28.5. Since my K is normal and BP controlled on one med, endo does not believe I might have PA. Endo says ratio 28.5 is just suggestive, not definitive (he looks for ratio of 30). However he ordered me off anti-hypertensives for a month, then will retest aldo/renin ratio; he said when I retest, if it is higher than 30, will proceed with saline infusion test. Article above has results of a study showing that saline infusion test for PA in normokalemia is not recommended. (They did not require patients be off anti-hypertensives.) Dr Grim, do you know this study?The study uses this ratio for diagnosis of PA: aldosterone/renin concentration >21 pg/ml:µU/ml. I don't know how pg/ml:µU/ml compares to my last results:Aldosterone result 37.4 ng/dLNormal ranges age 15 and older:Upright 4.0-31.0 ng/dLSupine 16.0 ng/dL or lessUnspecified 31.0 ng/dL or lessRenin, Plasma result 1.3 ng/mL/hrNormal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hrSupine 0.2-1.6 ng/mL/hr

[Guest guest]

No the tests are only needed after drugs and diet have failed to control Sx, BP and K and if MCRB Rx fails.CE Grim MDOn Feb 17, 2010, at 10:14 PM, Stone wrote:Does this saline infusion test or salt loading test I've read about make you sick? I can only have about 325 mcg of sodium and then get a myriad of symptoms that make me soooo sick like extreme heart palpitations and chest pressure, SOB, extreme nausea and dizziness,etc. I'm worried these test will make me feel horrible again. Are these absolutely needed for testing for PA? Re: research study about value of saline infusion test in diagnosing normokalemic PA WE developed the saline test and have done it in 1000s. Most PAs have a normal K if you read my article. Only advanced cases have low K. Be sure K is being drawn according to our guidelines in files.CE Grim MDOn Feb 17, 2010, at 11:26 AM, smkushka wrote:http://www.eje-online.org/cgi/content/full/154/6/865My aldo/renin ratio is 28.5. Since my K is normal and BP controlled on one med, endo does not believe I might have PA. Endo says ratio 28.5 is just suggestive, not definitive (he looks for ratio of 30). However he ordered me off anti-hypertensives for a month, then will retest aldo/renin ratio; he said when I retest, if it is higher than 30, will proceed with saline infusion test. Article above has results of a study showing that saline infusion test for PA in normokalemia is not recommended. (They did not require patients be off anti-hypertensives.) Dr Grim, do you know this study?The study uses this ratio for diagnosis of PA: aldosterone/renin concentration >21 pg/ml:µU/ml. I don't know how pg/ml:µU/ml compares to my last results:Aldosterone result 37.4 ng/dLNormal ranges age 15 and older:Upright 4.0-31.0 ng/dLSupine 16.0 ng/dL or lessUnspecified 31.0 ng/dL or lessRenin, Plasma result 1.3 ng/mL/hrNormal ranges Adult Normal sodium diet Upright 0.5-4.0 ng/mL/hrSupine 0.2-1.6 ng/mL/hr