Primary aldosteronism: a common and important problem. A practical guide to the diagnosis and treatment

In view of the fact that primary aldosteronism (PA) is a problem that is more prevalent than previously thought and its diagnosis is of greater clinical significance than previously believed, the Endocrine Society has recently published recommendations on the diagnosis and management of PA. Due to the fact that the currently available tests cannot be considered the gold standard in the diagnosis of PA and the discrepancies in the results of determination of aldosterone levels and plasma renin activity (PRA) are considerable the authors of this document do not provide strict cutoff values, leaving the interpretation of results to clinicians. This paper, which focuses on screening and confirmatory tests and on the aetiological diagnosis and treatment of PA, is based on the experience of the Department of Endocrinology, Diabetes and Internal Diseases, Medical University in Bialystok, Poland, but it also takes into account other points of view presented in papers published in the past few years.