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Rationale: In healthy individuals, aldosterone production is inversely correlated with salt intake.1,2 This test is based on the fact that aldosterone levels should be suppressed in individuals given a high salt diet. A urine aldosterone level >14 μg/24 hours after three days of a high salt diet is consistent with hyperaldosteronism.2
Protocol: The patient should consume a high salt diet supplemented with sodium chloride tablets (12 g/day) for three days. Starting on the morning of the third day, a 24-hour urine should be collected (no preservative) for measurement of sodium and aldosterone excretion. Urine sodium levels >200 mEq/24 hours to indicate adequate salt loading for proper test interpretation.1
Orderable Tests: See Comprehensive List of Procedures section for individual test information.
Note: Increasing dietary sodium chloride in patients with severe hypertension should be avoided. Potassium chloride replacement should be considered due to increased potassium excretion associated with a high salt diet.1