Biochemical Evaluation by Confirmatory Tests after Unilateral Adrenalectomy for Primary Aldosteronism

Table 1

Definition of clinical and biochemical outcomes in PASO criteria.

Clinical outcome	Complete	Normal BP without medication
	Partial	The same BP before Adx with less medication; Reduction in BP with either the same or less medication
	Absent	Unchanged or increased BP with the same or an increased medication
Biochemical outcome	Complete	Correction of hypokalemia; Normalization of ARR; In patient with a raised ARR, PAC should be suppressed in confirmatory tests
	Partial	Correction of hypokalemia; A raised ARR; ≥50% decrease in baseline aldosterone (compared with before Adx) and/or abnormal but improved result after Adx confirmatory tests
	Absent	Persistent hypokalemia; A persistent raised ARR; Failure to suppress PAC after Adx confirmatory tests

Criteria shown by Ref. [8] are adopted in this study. PASO: primary aldosteronism surgery outcome; BP: blood pressure; medication, antihypertensive medication; ARR: aldosterone-renin ratio; PAC: plasma aldosterone concentration; Adx: adrenalectomy. The same and unchanged BP levels are defined as a difference (before Adx vs after Adx) in systolic BP (SBP) of <20 mmHg and diastolic BP (DBP) of <10 mmHg; reduction or increase in BP is defined as a difference in SBP of ≥20 mmHg or DBP of ≥10 mmHg, or both; however, if a change in SBP and an opposing change in DBP are reported, the BP response is defined by the change in SBP. The same medication is defined as a change (decrease or increase) of less than 0.5 times the defined daily dose between before and after Adx; less medication is defined as a decrease of 0.5 or more times the defined daily dose between before and after Adx; and increased medication is defined as an increase of 0.5 or more times the defined daily dose between before and after Adx.