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New Serum Potassium Cut-Off Point for Improving Primary Aldosteronism Screening

Li, H.; Zhou, F.; Zhao, H.; Huang, W.; Wang, H.; Wang, S.

2026-07-02 endocrinology
10.64898/2026.06.30.26356983 medRxiv
Show abstract

This study enrolled 152 hypertensive patients with an ARR > 3.7 to assess the relationship between the traditional hypokalemia cutoff (3.5 mmol/L) and primary aldosteronism (PA) screening, and to establish a new cutoff. Under the traditional cutoff, only 35.7% of PA patients presented with hypokalemia. ROC curve analysis identified a new cutoff of 4.22 mmol/L, which increased sensitivity from 35.7% to 77.5%, with a specificity of 91.1% and an AUC of 0.897. The findings indicate that the traditional cutoff is insufficiently sensitive, while the new cutoff markedly improves screening sensitivity and facilitates early detection of PA.

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