Goldenberg K, Snyder D K
J Gen Intern Med. 1986 Nov-Dec;1(6):368-72. doi: 10.1007/BF02596419.
A serum potassium determination is usually recommended for new hypertensive patients as a screening test for primary aldosteronism and as a baseline for drug therapy. Since hypokalemia is not specific for aldosteronism, the authors assessed its use and limitations as a screening test in nine reported studies of 303 patients with aldosterone-producing adenomas (n = 252) or adrenal hyperplasia (n = 51). The optimal potassium cutoff level and the predictive ability of hypokalemia to detect aldosteronism were analyzed in a primary care setting with different diseases, test characteristics, and prevalences. Optimal screening for primary aldosteronism occurred at serum potassium less than 3.2 mEq/l in a primary care, low-prevalence population, and at higher potassium levels in higher-prevalence populations. Other screening tests, such as urinary aldosterone levels and plasma renin activity, showed lower individual test performance characteristics, but when combined were similar in performance to serum potassium measurement.
通常建议对新诊断的高血压患者进行血清钾测定，作为原发性醛固酮增多症的筛查试验以及药物治疗的基线。由于低钾血症并非醛固酮增多症所特有，作者在9项针对303例醛固酮分泌腺瘤患者（n = 252）或肾上腺增生患者（n = 51）的报告研究中评估了其作为筛查试验的应用及局限性。在具有不同疾病、检测特征和患病率的初级保健环境中，分析了低钾血症检测醛固酮增多症的最佳血钾临界值水平和预测能力。在初级保健、低患病率人群中，血清钾低于3.2 mEq/L时对原发性醛固酮增多症进行最佳筛查，而在高患病率人群中则在更高的血钾水平进行筛查。其他筛查试验，如尿醛固酮水平和血浆肾素活性，单项检测性能特征较低，但联合使用时性能与血清钾测量相似。
