Wu, Che-HsiungChe-HsiungWuYA-WEN YANGHu, Ya-HuiYa-HuiHuTsai, Yao-ChouYao-ChouTsaiKuo, Ko-LinKo-LinKuoYEN-HUNG LINHung, Szu-ChunSzu-ChunHungVIN-CENT WUKWAN-DUN WUYI-LWUN HOChang H.-W.LIAN-YU LINLiu K.-L.KAO-LANG LIUSHUO-MENG WANGKUO-HOW HUANGYUNG-MING CHENChang C.-C.CHIN-CHEN CHANGSHIH-CHIEH CHUEHCHING-CHU LUShih-Cheng LiaoRUOH-FANG YEN2020-03-272020-03-2720131932-6203https://scholars.lib.ntu.edu.tw/handle/123456789/479448Background: Historically, urinary aldosterone level measurement was a commonly employed confirmatory test to detect primary aldosteronism (PA). However, 24-h urine collection is inconvenient and cumbersome. We hypothesized that random urinary aldosterone measurements with correction for creatinine concentration might be comparable to 24-h urinary aldosterone levels (Uald-24 h) in the diagnosis of PA. Methods: The non-concurrent prospective study was conducted between June 2006 and March 2008 in patients admitted for confirmation of aldosteronism by salt loading test. A 24-h urine sample, which was collected during hospitalization on the day before saline infusion testing after restoration of serum hypokalemia, was collected from all subjects. Moreover, participants were asked to collect a first bladder voiding random urine sample during clinic visits. Uald-24 h and the random urinary aldosterone-to-creatinine ratio (UACR) were calculated accordingly. Results: A total of 102 PA patients (71 patients diagnosed of aldosterone-producing adenoma, 31 with idiopathic hyperaldosteronism) and 65 patients with EH were enrolled. The receiver operating characteristic curve showed comparable areas under the curves of UACR and Uald-24 h. The Bland-Altman plot showed mean bias but no obvious heteroscedasticity between the two tests. When using random UACR >3.0 ng/mg creatinine as the cutoff value, we obtained a specificity of 90.6% to confirm PA from essential hypertension. Conclusions: Our study reinforce that the diagnostic accuracy of random UACR was comparable to that of Uald-24 h in PA patients. With the quickness and simplicity of the UACR method and its equivalence to Uald-24 h, this assay could be a good alternative diagnostic tool for PA confirmation.journal article10.1371/journal.pone.0067417238406952-s2.0-84879515409