Need To understand this investigation in STEP-Up To Medicine 3rd ??

[agabozy]

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P.186
for Definitive diagnosis of primary hyperaldosteronism

Oral sodium loading • The patient is given a high salt diet for 3 days. Serum and urine electrolytes, aldosterone, and creatinine are measured on the third day.
High urine aldosterone in the setting of high urine sodium (to document appropriate sodium loading) confirms the diagnosis.

***why is there high urine sodium although excess aldosterone lead to excessive sodium retention ??????

***what this mean "(to document appropriate sodium loading)" ????

Thanks

 

[HopeTo99]

Simply put:
To screen for primary hyperaldosteronism, renin should be suppressed whereas aldosterone is high.
Now to confirm, you would give an IV load of isotonic fluids or salt and check the response. Normally aldosterone would be suppressed. If it is not: Hyperaldosteronism.
Next step would be to do a CT scan of the abdomen to look for an adenoma for e.g.