Which is the screening test for evaluation of mineralocoicoid excess?
The accepted screening test for mineralocoicoid excess is aldosterone renin ratio. Since the leading cause is Adrenal Adenoma, the autonomous aldosterone values will rise and renin values will be low due to feedback. ARR screening is positive if ratio is > 750pmol/L per ng/ml. Spironolactone should be discontinued for at-least 4 weeks before performing this test for obvious reasons. This is followed by performance of investigation of choice for mineralocoicoid excess which is Saline infusion test.
Saline infusion test
Salt loading test
Cosyntropin test
Aldosterone renin ratio
Disorders of Adrenal Gland