• Vin-Cent Wu, Ya-Hui Hu, Leay Kiaw Er, Ruoh-Fang Yen, Chia-Hui Chang, Ya-Li Chang, Ching-Chu Lu, Chin-Chen Chang, Jui-Hsiang Lin, Yen-Hung Lin, Tzung-Dau Wang, Chih-Yuan Wang, Shih Te Tu, Jeff ChuehShih-ChiehSCGlickman Urological and Kidney Institute, and Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA., Ching-Chung Chang, Fen-Yu Tseng, Kwan-Dun Wu, and TAIPAI group.
• Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2017 Dec 1; 116 (12): 993-1005.

Background/PurposeEven though the increasing clinical recognition of primary aldosteronism (PA) as a public health issue, its heightened risk profiles and the availability of targeted surgical/medical treatment being more understood, consensus in its diagnosis and management based on medical evidence, while recognizing the constraints of our real-world clinical practice in Taiwan, has not been reached.MethodsThe Taiwan Society of Aldosteronism (TSA) Task Force acknowledges the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics into the management of PA.ResultsWhen there is suspicion of PA, a plasma aldosterone to renin ratio (ARR) should be obtained initially. Patients with abnormal ARR will undergo confirmatory laboratory and image tests. Subtype classification with adrenal venous sampling (AVS) or NP-59 nuclear imaging, if AVS not available, to lateralize PA is recommended when patients are considered for adrenalectomy. The strengths and weaknesses of the currently available identification methods are discussed, focusing especially on result interpretation.ConclusionWith this consensus we hope to raise more awareness of PA among medical professionals and hypertensive patients in Taiwan, and to facilitate reconciliation of better detection, identification and treatment of patients with PA.Copyright © 2017. Published by Elsevier B.V.

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