Horm Metab Res 2017; 49(12): 977-983
DOI: 10.1055/s-0043-119802
Review
© Georg Thieme Verlag KG Stuttgart · New York

Primary Aldosteronism: The Next Five Years

John W. Funder
1  Hudson Institute of Medical Research and Monash University, Clayton, Australia
› Author Affiliations
Further Information

Publication History

received 06 August 2017

accepted 07 September 2017

Publication Date:
24 October 2017 (online)

Abstract

The management of primary aldosteronism is widely varied within various published guidelines, with very little in the way of data supporting the choice of one variation over others. Current estimates of prevalence are probably accurate for aldosterone producing adenoma, but fall very short of that for bilateral adrenal hyperplasia. Discovery at the level of basic science has proven illuminating over the past 6 years in terms of unilateral disease and both somatic and germline mutations, with much less focus on the much more common bilateral disease; Attempts at harmonization have begun – for example, criteria for complete/partial/absent cure after adrenalectomy for unilateral disease; again focus on bilateral disease is muted. A number of possibilities are suggested as agenda for active consideration and change, across a wide range of areas – referral patterns, screening, confirmation and lateralization, what will be needed is discussion and agreement, to fill the lacunae within the current guidelines. Those involved will want to change to make such an agenda possible.