Spironolactone test

The spironolactone test is carried out by the following principle. Spironolactone has the effect of protecting aldosterone from sodium and potassium in the distal renal tubules. If the dose is sufficient, the urinary potassium excretion of patients with aldosteronism can be reduced. Hypokalemia is corrected, approaching or reaching normal potassium levels; and lowering its elevated blood pressure, even to normal levels. After taking dexamethasone in patients with hyperaldosteronism, blood potassium increased significantly, approaching or reaching normal levels, and 24-hour urinary potassium excretion decreased. Basic Information Specialist classification: urinary examination classification: urine / kidney function test Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to the normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Normal value Aldosterone secretion is normal. Clinical significance After taking dexamethasone in patients with hyperaldosteronism, blood potassium increased significantly, approaching or reaching normal levels, and 24-hour urinary potassium excretion decreased. Some patients with high blood sodium and alkali poisoning, high blood sodium and alkali poisoning returned to normal. Those who are satisfied with the drop in blood pressure suggest that the patient is likely to return to normal after surgery, and those who are not satisfied with the blood pressure drop often tend to return to normal after surgery. This test helps to prove the presence of aldosteronism, but does not identify primary or secondary aldosteronism. Abnormal results: There are three types of clinical symptoms of aldosteronism. 1. Hypertensive patients have high blood pressure, and appear earlier, often appear in about 4 years before the onset of hypokalemia. Generally, it is moderately elevated, and the increase in diastolic blood pressure is more obvious. 2. Neuromuscular dysfunction (1) Neuromuscular weakness and paralysis Generally speaking, the lower the blood potassium, the heavier the myopathy. Tiredness, coldness, tension, diarrhea, sweating, and loss of potassium-diuretic diuretics (such as hydrochlorothiazide, furosemide) can be induced. It is often found that the lower limbs cannot move autonomously when they wake up in the morning. The severity of the attack varies, and the severe one can affect the upper limbs, sometimes involving the respiratory muscles. Cranial nerve innervation muscles are generally unaffected. Bilateral flaccid convulsions at the time of onset. (2) Paroxysmal hand, foot and ankle and muscle spasm were found in about 1/3 of patients, with beam arm compression sign (Trousseau sign) and facial nerve attack sign (Chvostek sign). It can last for days to weeks. Can appear alternately with paroxysmal paralysis. 3. Loss of potassium nephropathy and pyelonephritis. People who need to be examined: patients with hypertension, neuromuscular dysfunction, potassium-deficient nephropathy and pyelonephritis. Precautions Forbidden before examination: pay attention to normal diet, pay attention to normal work and rest, and prevent endocrine disorders. Requirements for inspection: Actively cooperate with the doctor's request. On the third day of eating a fixed diet, 24 hours of urine was collected, and potassium, sodium, and chlorine were examined. On the fourth day, blood, potassium, sodium, chlorine, and carbon dioxide (or blood gas analysis) were used as controls. Oral spironolactone is used to measure the binding of potassium, sodium, chloride and carbon dioxide (or blood gas analysis) for 24 hours. Blood pressure was measured once in the morning and evening of the control period and the experimental period. Inspection process [method]: 1, fixed diet (sodium 160mEq / day, potassium 60mEq / day) 7-14 days. 2, on the third day of eating a fixed diet, take 24-hour urine, check potassium, sodium, chlorine, blood on the fourth day to check the potassium, sodium, chlorine and carbon dioxide binding (or blood gas analysis) as a control. 3, from the 4th day, daily oral spironolactone 60-80mg, 1 / 6 hours (also available at 7, 12, 17, 22 times 4 times). The binding of potassium, sodium, chloride and carbon dioxide (or blood gas analysis) was measured once every 3-4 days for urinary potassium, sodium, chlorine and blood. 4. Blood pressure was measured once a day in the morning and evening of the control period and the experimental period. Not suitable for the crowd Inappropriate crowd: temporarily unknown. Adverse reactions and risks Nothing.