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Recruiting Observational

Study on Cutoff Revision Effects and Evaluation of NNT in Primary Aldosteronism

NCT07621458 · tracked via the Priya Life Science South Korea tracker
Phase
Observational
Started
2026-04-01
Last updated
2026-06-02

Condition(s) studied

Primary Aldosteronism

Investigational drug(s) / intervention(s)

Saline Infusion Test

Saline Infusion Test: Standardized saline infusion test performed for confirmatory diagnosis of primary aldosteronism.

Study summary

The goal of this observational study is to evaluate the real-world impact of applying the revised aldosterone-to-renin ratio (ARR) cutoff recommended in the 2025 primary aldosteronism guideline in adults with hypertension and biochemical findings suggestive of an intermediate probability of lateralizing primary aldosteronism (PA). The main questions it aims to answer are:

* What is the number needed to test (NNT) to diagnose one case of primary aldosteronism when using the revised ARR cutoff (\>20)?
* What is the optimal ARR cutoff for diagnosing PA in Korean patients?
* What is the biochemical treatment response rate at 6 months after treatment for confirmed PA?

Participants will:

* Undergo standardized ARR testing after protocol-based medication adjustment and controlled sampling conditions.
* Undergo confirmatory testing using the saline infusion test (SIT).
* Receive standard clinical management for confirmed PA according to institutional practice.
* Be followed for assessment of biochemical outcomes after treatment.

Eligibility

Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria: * Adults aged 18 years or older * Diagnosis of hypertension or current use of antihypertensive medications * Plasma renin activity (PRA) ≤1 ng/mL/hr * Plasma aldosterone concentration (PAC) ≥10 ng/dL by immunoassay or ≥7.5 ng/dL by liquid chromatography-tandem mass spectrometry (LC-MS/MS) * Aldosterone-to-renin ratio (ARR) \>20 by immunoassay or \>15 by LC-MS/MS * Participants meeting criteria for intermediate probability of lateralizing primary aldosteronism * For participants with ARR values between 20 and 30, repeat ARR measurement within 26 weeks demonstrating persistent ARR \>20 Exclusion Criteria: * Current use of mineralocorticoid receptor antagonists or amiloride that cannot be discontinued according to study protocol * Previous adrenalectomy * Chronic kidney disease stage 4 or higher (estimated glomerular filtration rate \<30 mL/min/1.73 m²) * Pregnancy * Current use of combined estrogen- and progesterone-containing oral contraceptive pills or hormone replacement therapy * High probability primary aldosteronism defined as hypokalemia with PRA \<0.2 ng/mL/hr and PAC \>20 ng/dL by immunoassay or \>15 ng/dL by LC-MS/MS * Low probability primary aldosteronism defined as PAC \<11 ng/dL by immunoassay or \<8 ng/dL by LC-MS/MS * Inability to undergo saline infusion test according to investigator judgment

Primary outcome measure(s)

  • Number Needed to Test for Diagnosis of Primary Aldosteronism — Through study completion, an average of 6 months
    Number of saline infusion tests required to confirm one case of primary aldosteronism among participants meeting the revised aldosterone-to-renin ratio screening cutoff criteria.

Trial sites (1)

FacilityCityRegionStatus
Seoul National University Hospital Seoul Korea, Republic of Recruiting
Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07621458 on ClinicalTrials.gov ↗ ← All trials in South Korea