Betydelsen av binjurevenskateterisering vid primär aldosteronism. Nödvändig undersökning för många patienter då
datortomografi kan leda fel
Sammanfattning
Primary aldosteronism is the cause of hypertension in 5-10% of the hypertensive population. Almost half of all patients with
primary aldosteronism have unilateral disease, i.e. the dominating aldosterone production derives from one of the adrenal glands,
and the rest have bilateral disease. The treatment of choice for patients with unilateral disease is unilateral
laparoscopic/retroperitoneoscopic adrenalectomy. One-third of patients with unilateral disease have normal adrenal glands on
imaging studies or changes in both of the adrenal glands. Similarly, 30% of patients with bilateral excessive aldosterone production
have radiological evidence of adenoma in only one of the adrenal glands. Adrenal vein sampling should be considered mandatory in
patients with primary aldosteronism prior to surgical treatment.