Spironolactone test

The spironolactone test is an auxiliary test method for checking whether the urination function is normal. Spironolactone can competitively antagonize the potassium excretion effect of aldosterone in the renal distal convoluted tubules, but does not inhibit the synthesis and secretion of aldosterone, and has no direct effect on renal tubules. After administration of spironolactone in patients with primary aldosteronism, the renal potassium can be reduced, sodium excretion increased, blood potassium increased, and blood sodium decreased. Basic Information Specialist classification: urinary examination classification: urine / kidney function test Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: normal. Positive: Primary aldosteronism, secondary aldosteronism, test positive, that is, blood potassium was significantly higher than the baseline value after taking the drug, urinary potassium decreased, blood sodium, CO2CP and blood pressure decreased. Tips: Maintain normal sleep and diet. Normal value This test is negative. Clinical significance Abnormal results: The changes of serum potassium, sodium, chloride, CO2CP and 24h urinary potassium excretion before and after taking the drug were observed, and blood potassium was the main evaluation index. After taking the drug, the blood potassium concentration was significantly higher than the control value, and the test was positive at or near normal. This test can only diagnose the presence of increased aldosterone secretion, but can not identify primary and secondary aldosterone. 1. Primary aldosteronism, secondary aldosteronism, test positive, that is, blood potassium is significantly higher than the baseline value after taking the drug, urinary potassium is reduced, blood sodium, CO2CP and blood pressure are decreased. If the blood pressure drops to normal, it may be an adrenal adenoma. If it does not fall to normal, it is mostly adrenal hyperplasia. 2. Predict the effect of surgery. Satisfactory blood pressure after taking the drug indicates that the blood pressure is likely to return to normal after surgery. Otherwise, the postoperative blood pressure may not be easily recovered or decreased slowly. 3. Hypokalemia and hypertension caused by kidney disease, the test is negative. People in need of examination: suspected hyperaldosteronism, primary aldosteronism for surgery. Positive results may be diseases: precautions for aldosteronism in children Taboo before check: Maintain normal sleep and diet. Requirements for examination: If the blood potassium level is too high during the test, the test can be judged positive and the test is terminated. It is not necessary to adhere to the test for 7 days. Inspection process 1. In the control period and the test period, fixed sodium (150mmol/d), potassium (50mmol/d) diet, distilled water, and blood pressure twice daily. 2. In the control period, the blood potassium, sodium, chlorine, carbon dioxide binding capacity (CO2CP) and 24h urinary potassium excretion were measured more than 2 times for 3d-7d, and the ECG was performed once. If there are 2 or more times of potassium 3-4mmol / L, 24h urinary potassium excretion > 30mmol, drug testing can be carried out. 3. Test phase: lasts from 1 week to 2 weeks. Daily oral spironolactone microparticles 320mg-400mg, or 900mg tablets, divided into 2 times -4 times orally. The ECG was performed once a day or every other day, and the potassium, sodium, chlorine, CO2CP and 24h urinary potassium excretion were measured once every 3 days. Not suitable for the crowd Inappropriate population: Primary aldosteronism with clear diagnosis and non-surgical treatment. Adverse reactions and risks No related complications or hazards.

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