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Behind The Knife: The Surgery Podcast cover image

Clinical Challenges in Endocrine Surgery: Adrenalectomy Guidelines Review

Behind The Knife: The Surgery Podcast

NOTE

Ratio of aldosterone cortisol as indicator for unilateral operation

A ratio of at least 4:1 cortisol-aldosterone is required to benefit from a unilateral operation for unilateral disease./nA ratio of around 3.5 or 3.7 may be sufficient to proceed with surgery if there's an adrenal nodule on that side./nA ratio of 1 indicates bilateral disease and it's harder to make a case for surgery based on ABS./nStopping spironolactone for ABS is traditional, but if renin is suppressed, it may interfere with ABS results./nTypically spironolactone dose is not high enough to suppress renin.

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