Response to “Letter to the Editor regarding the report entitled Urinary sodium/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension”
Response to “Letter to the Editor regarding the report entitled Urinary sodium/potassium ratio as a screening tool for hyperaldosteronism in men with hypertension”
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回应“关于题为尿钠/钾比作为高血压男性醛固酮增多症筛查工具的报告的致编辑的信”
DOI：
10.1038/s41440-021-00834-8
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发表时间：
2022
影响因子：
5.4
通讯作者：
Ueshima Hirotsugu
中科院分区：
文献类型：
--
作者：
Segawa Hiroyoshi;Higashi Akane;Yoshii Kengo;Iwahori Toshiyuki;Ueshima Hirotsugu
我们感谢你给我们机会答复我们在信中提出的与我们的报告有关的问题，并提供详细资料，以解决这些关切。在信中，作者指出了对在我们评价醛固酮增多症筛查期间未采用较低阴性可能性测试的担忧[1]。我们同意，一般来说，较低的阴性似然测试可以有效地避免漏诊疾病。在我们的研究结果中，如果第二次晨尿Na/K比值（SMU Na/K）高于3.0，则醛固酮增多症的可能性很低[2]。然而，使用筛查工具来检测适合进行详细检查的受试者也很重要。即使受试者的SMU Na/K小于3.0，醛固酮增多症的概率也仅为14.7%（[2]中的表3）。在没有特殊饮食或严格饮食控制的情况下，更多的人可能会达到3.0的临界点，因为自我监测干预下的平均尿Na/K比值达到3.2 [3]。因此，将截止点设置为3.0可能会导致许多不必要的详细检查。有理由推断，应鉴别尿Na/K值低的患者
We would like to thank you for the opportunity to respond to the issues raised in the letter related to our report and for providing detailed information to address these concerns. In the letter, the author noted concerns regarding a lower negative likelihood test not being employed during our evaluation of hyperaldosteronism screening [1]. We agree that, in general, a lower negative likelihood test can be effectively employed to avoid missing the detection of a disease.In our study results, the possibility of hyperaldosteronism was low if the second morning urine Na/K ratio (SMU Na/K) was higher than 3.0 [2]. However, it is also important to use a screening tool to detect subjects for whom detailed examinations are appropriate. The probability of hyperaldosteronism is only 14.7%, even if a subject, s SMU Na/K is less than 3.0 (Table 3 in [2]. A larger number of people may reach a cutoff point set at 3.0 without either a special diet or strict dietary control since the mean urinary Na/K ratio of people under the self-monitoring intervention reached 3.2 [3]. Thus, setting the cutoff point at 3.0 may lead to many unnecessary detailed examinations. It is reasonable to infer that patients showing a low urinary Na/K should be identified
通过尿Na/K比值筛查原发性醛固酮增多症的临界点是否合适？
影响因子：
5.4
作者：
T. Shimosawa
通讯作者：
T. Shimosawa