What we still do not know about adrenal vein sampling for primary aldosteronism

R. J. Auchus, F. H. Wians, M. E. Anderson, B. L. Dolmatch, C. K. Trimmer, S. C. Josephs, D. Chan, S. Toomay, F. E. Nwariaku

Research output: Contribution to journalReview articlepeer-review

42 Scopus citations


During the last two decades, primary aldosteronism has emerged as the most common cause of secondary hypertension, and advances in the diagnosis and treatment of this condition have improved patient care substantially. A major stumbling block in the evaluation and management of these patients, which ultimately guides treatment and prognosis, is answering the question, Which adrenal gland(s) produce aldosterone? Adrenal vein sampling has emerged as the only reliable method to determine the answer to this question; however, the methodology and criteria for lateralization have been determined empirically with little prospective data. The major remaining controversies surrounding adrenal vein sampling include: who should perform and who should undergo the procedure; what criteria should be used to define a successful study and lateralization of aldosterone production; whether cosyntropin should be infused during the procedure and how; and what to do when results are ambiguous? This article reviews some of the advances in the execution of this procedure, the variations in procedure, the data that fuel the controversies, and the issues that need to be resolved in the future.

Original languageEnglish (US)
Pages (from-to)411-415
Number of pages5
JournalHormone and Metabolic Research
Issue number6
StatePublished - Jun 4 2010


  • Adrenal adenoma
  • Aldosterone
  • Mineralocorticoid
  • Renin-angiotensin-aldosterone systems
  • Steroid hormones

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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