Investigations

If primary hyperaldosteronism suspected

• renin and aldosterone levels ^c

Why?

Aldosterone and renin levels can help diagnose and exclude primary hyperaldosteronism

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
suspected primary hyperaldosteronism c (pre-test probability: 0.6%)	primary hyperaldosteronism (biochemistry and imaging studies)	supine aldosterone > 179 pg/ml	3.8 (2.7 to 5.4)	2.2%	0.11 (0.0047 to 0.26)	0.066%
		supine aldosterone: renin ratio > 22	17 (6.5 to 46)	9.5%	0.31 (0.21 to 0.46)	0.19%
		erect renin < 26 pg/ml	1.5 (1.2 to 1.8)	0.90%	0.38 (0.20 to 0.69)	0.23%