Aldosterone suppression evaluation panel (eg, saline infusion) This panel must include the following: Aldosterone (82088 x 2) Renin (84244 x 2)
CPT4 code
Name of the Procedure:
Aldosterone Suppression Evaluation Panel (Saline Infusion)
Summary
The Aldosterone Suppression Evaluation Panel is a diagnostic test used to measure the levels of aldosterone and renin in the blood. This panel helps to assess how aldosterone levels are controlled within the body when saline is infused.
Purpose
The test is primarily used to diagnose conditions related to abnormal aldosterone production, such as primary aldosteronism (Conn's syndrome). The goal is to determine if aldosterone levels remain abnormally high when the body fluid volume is increased, which indicates an issue with aldosterone regulation.
Indications
- Hypertension (high blood pressure) that is difficult to control.
- Unexplained low blood potassium levels.
- Signs of hyperaldosteronism.
- Suspicion of adrenal gland tumor.
Preparation
- Patients may be required to stop certain medications (such as diuretics) that can affect test results.
- Patients should follow a high-sodium diet for a specific period before the test.
- Fasting may be required for a few hours prior to the procedure.
Procedure Description
- Initial Blood Draws: Blood samples are taken to measure baseline aldosterone and renin levels.
- Saline Infusion: A saline solution is infused into the patient's veins over a set period, typically 4 hours.
- Monitoring: The patient's blood pressure and electrolyte levels are monitored during the infusion.
- Final Blood Draws: Additional blood samples are taken post-infusion to measure aldosterone and renin levels again.
Tools: Intravenous infusion set, blood collection tubes, saline solution. No anesthesia or sedation is typically required.
Duration
The entire procedure, including preparation, infusion, and blood draws, typically takes around 4-5 hours.
Setting
This procedure is generally performed in an outpatient clinic or hospital setting.
Personnel
- A nurse or medical technician to perform the blood draws and manage the saline infusion.
- An endocrinologist or healthcare provider specializing in hormonal disorders.
Risks and Complications
- Common: Bruising at the site of blood draw, slight discomfort during IV insertion.
- Rare: Phlebitis (inflammation of the vein), adverse reactions to saline infusion.
Benefits
- Provides crucial information for diagnosing hyperaldosteronism.
- Helps in guiding appropriate treatment strategies.
- Results can often be obtained within a few days to a week.
Recovery
- Patients can typically resume normal activities immediately after the procedure.
- Follow-up appointments may be scheduled to discuss test results and next steps.
Alternatives
- Other diagnostic tests for aldosterone and renin without saline infusion.
- Imaging studies (CT or MRI) to assess adrenal gland abnormalities.
- Pros: Non-invasive alternatives, quicker procedures.
- Cons: May not provide as definitive or specific diagnostic information.
Patient Experience
- During the procedure: Patients may experience a sensation of coldness from the saline infusion and minor discomfort from blood draws.
- After the procedure: Mild bruising or soreness at the blood draw site, which can be managed with over-the-counter pain relief or ice packs.