| Association of kidney function with residual hypertension after treatment of aldosterone-producing adenoma. | |
| | |
MedLine Citation:
|
PMID: 19628318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Autonomous secretion of aldosterone in patients with primary aldosteronism increases glomerular filtration rate and causes kidney damage. The influence of a mild decrease in kidney function on residual hypertension after adrenalectomy is unexplored. STUDY DESIGN: Nonconcurrent prospective study. SETTING & PARTICIPANTS: The study was based on the Taiwan Primary Aldosteronism Investigation (TAIPAI) database. 150 patients (61 men; overall mean age, 47.2 +/- 11.6 years) with a diagnosis of aldosterone-producing adenoma had undergone unilateral adrenalectomy at National Taiwan University Hospital from July 1999 to January 2007. PREDICTOR: Presurgery estimated glomerular filtration rate (eGFR). OUTCOMES & MEASUREMENTS: Residual hypertension after adrenalectomy, defined either as less than 75% of recorded blood pressure measurements with systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg or requiring antihypertensive medications during the first year after surgery. RESULTS: Before surgery, 27 (18%), 72 (48%), and 51 (34%) patients had moderately to severely decreased (<60 mL/min/1.73 m(2)), mildly decreased (60 <or= eGFR < 90 mL/min/1.73 m(2)), or nondecreased eGFR (>or=90 mL/min/1.73 m(2)), respectively. After surgery, 16 (59.3%), 29 (40.3%), and 10 (19.3%) patients in each category had postsurgery residual hypertension. Compared with patients without decreased eGFR before surgery, adjusted odds ratios for postsurgery residual hypertension were 2.7 (95% confidence interval, 1.03 to 7.0; P = 0.04) and 2.8 (95% confidence interval, 1.05 to 9.3) for mildly and moderately to severely decreased eGFR, respectively. LIMITATIONS: Arbitrary definition for residual hypertension. CONCLUSIONS: Two-thirds of patients with aldosterone-producing adenoma were cured of hypertension by means of unilateral adrenalectomy. Kidney function impairment, even mild, appears to be associated with a high incidence of postsurgery residual hypertension. |
| | |
Authors:
|
; Vin-Cent Wu; Shih-Chieh Chueh; Hung-Wei Chang; Lian-Yu Lin; Kao-Lang Liu; Yen-Hung Lin; Yi-Luwn Ho; Wei-Chou Lin; Shuo-Meng Wang; Kuo-How Huang; Kuan-Yu Hung; Tze-Wah Kao; Shuei-Liong Lin; Ruoh-Fang Yen; Yung-Ming Chen; Bor-Sen Hsieh; Kwan-Dun Wu |
Related Documents
:
|
7485478 - Determinants of cardiac fibrosis in experimental hypermineralocorticoid states. 10338428 - Posttraumatic hypertension secondary to adrenal hemorrhage mimicking pheochromocytoma: ... 1267118 - Enflurane anaesthesia for removal of aldosterone producing adenoma. 10220638 - High-dose enoximone to evaluate reversibility of pulmonary hypertension: is there a dia... 17684518 - Increases in cerebrospinal fluid caffeine concentration are associated with favorable o... 8173708 - Feasibility and drug delivery efficiency of a new balloon angioplasty catheter capable ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-07-23 |
Journal Detail:
|
Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 54 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2009 Oct |
Date Detail:
|
Created Date: 2009-09-28 Completed Date: 2009-10-02 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
|
Languages: eng Pagination: 665-73 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenoma
/
blood,
complications,
physiopathology*,
secretion,
surgery Adrenal Cortex Neoplasms / blood, complications, physiopathology*, secretion, surgery Adrenalectomy* Adult Aldosterone / blood*, secretion Blood Pressure Creatinine / blood Female Glomerular Filtration Rate* Humans Hyperaldosteronism / blood, etiology, metabolism, physiopathology Hypertension / blood, etiology, metabolism, physiopathology* Kidney / metabolism, physiopathology* Kidney Function Tests Male Middle Aged Odds Ratio Retrospective Studies Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
|
52-39-1/Aldosterone; 60-27-5/Creatinine |
| Investigator | |
Investigator/Affiliation:
|
Vin-Cent Wu / ; Yen-Hung Lin / ; Yi-Luwn Ho / ; Hung-Wei Chang / ; Lian-Yu Lin / ; Fu-Chang Hu / ; Kao-Lang Liu / ; Shuo-Meng Wang / ; Kuo-How Huang / ; Fang-Chi Chang / ; Yung-Ming Chen / ; Chin-Chi Kuo / ; Shih-Chieh Chueh / ; Ching-Chu Lu / ; Fang-Chi Chang / ; Shih-Cheng Liao / ; Ruoh-Fang Yen / ; Wei-Chou Lin / ; Bor-Sen Hsieh / ; Kwan-Dun Wu / ; Fen-Fun Hsien / |
| Comments/Corrections | |
Comment In:
|
Am J Kidney Dis. 2009 Oct;54(4):594-7
[PMID:
19781452
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Growth restriction at birth and kidney function during childhood.
Next Document: Homocysteine lowering and cognition in CKD: the Veterans Affairs homocysteine study.