[Establishment and validation of a nomogram-based predictive model for idiopathic aldosteronism]

Area of Science:

• Endocrinology
• Nephrology
• Internal Medicine

Context:

• Idiopathic hyperaldosteronism (IHA) is a subtype of primary aldosteronism (PA).
• Accurate differentiation between IHA and unilateral PA (UPA) is crucial for treatment decisions.
• Current diagnostic methods can be complex and time-consuming.

Purpose:

• To develop and validate a nomogram-based predictive model for IHA.
• To identify key clinical and biochemical predictors of IHA.
• To facilitate the selection of patients with IHA who may benefit from direct medical management.

Summary:

• A cross-sectional study involving 356 PA patients (249 UPA, 107 IHA) developed a nomogram using serum potassium, plasma renin concentration (PRC), plasma aldosterone concentration post-saline infusion test (PAC post-SIT), and unilateral adrenal nodule rate.
• The model demonstrated good predictive performance, with a total score ≥14 achieving 65% sensitivity and 90% specificity in the training cohort, and 56% sensitivity and 100% specificity in the validation cohort.
• Key predictors identified were serum potassium, PRC, PAC post-SIT, and unilateral adrenal nodule rate.

Impact:

• Provides a validated, non-invasive tool for predicting IHA.
• Aids in clinical decision-making for PA patients, potentially reducing the need for more invasive tests.
• Enhances diagnostic efficiency and facilitates timely, targeted treatment for IHA.