Incidence of Primary Aldosteronism in Patients with Hypokalemia (IPAHK+): Study Design and Baseline Characteristics

Abstract

Hypokalemia plays a central role for case finding, course, treatment decision, and prognosis of patients with primary aldosteronism. However, to date there is a lack of high-level evidence about the incidence of primary aldosteronism in hypokalemic patients. The IPAHK+study is an epidemiological, cross-sectional, monocentric study to provide evidence on the incidence of PA in a hypokalemic population. The aim of the current analysis was to describe the baseline characteristics of the first 100 patients eligible for study inclusion. The recruitment of patients with hypokalemia (≤3 mmol/l) is carried out continuously on a referral-basis by the central laboratory of the University Hospital Zurich through an automated suitability testing and data delivery system. The careful evaluation of the first 100 reported patients was based on the available reporting system. Out of 28 140 screened patients, 222 (0.79%) were identified with a serum potassium value of≤3 mmol/l (mean 2.89±0.02 mmol/l). Mean potassium levels were slightly lower in non-hypertensive subjects compared to hypertensive subjects (mean difference 0.07 mmol/l, p=0.033), while no significant difference was found between the sexes and patients with and without the diagnosis of primary aldosteronism, atrial fibrillation, or the use of diuretics. The incidence of PA was 4% in the total population studied and 7.5% in the subgroup of hypertensive patients. In conclusion, the continuous enrollment of patients from the IPHAK+hypokalemia registry into the IPAHK+trial will provide evidence about the actual incidence of primary aldosteronism in a hypokalemic outpatient population.

International Roadshow: New Advances in Endocrinology and Metabolic Diseases

“…Gruber et al have investigated a group of hypokalemia patients for incidences of primary aldosteronism (Conn's Syndrome) and found that more than 4 out of 10 patients had primary aldosteronism. This suggests that hypertensive individuals with moderate or severe hypokalemia should right away be evaluated for primary aldosteronism [13]. The last part of the special issue focuses on COVID-19 and Long-COVID.…”

Unawareness of Primary Aldosteronism as a Common Cause of Hypokalemia – Insights from the IPAHK+ Trial (Incidence of Primary Aldosteronism in Patients with Hypokalemia)

“…The study was conducted as previously detailed [8]. IPAHK + was designed as an epidemiological cross-sectional monocentric study including patients with defined hypokalemia, performed at the University Hospital Zurich (USZ) in Switzerland.…”

“…The diagnosis of PA in this study followed the internationally recommended routine procedure. Each step was performed as previously described [8]. If required, any established antihypertensive therapy was temporarily switched to verapamil slow-release 120 to 240 mg twice daily and/or doxazosin 4 to 8 mg once daily for one or four weeks, depending on the initial medication.…”