Document Detail

Kidney impairment in Primary Aldosteronism.
MedLine Citation:
PMID:  21345337     Owner:  NLM     Status:  Publisher    
BACKGROUND: Kidney impairment is noted in primary aldosteronism (PA), and probably initiated by glomerular hyperfiltration. METHODS: A prospectively defined survey was conducted of 602 patients who were suspected of PA in the multiple-center Taiwan Primary Aldosteronism Investigation (TAIPAI) database. Estimated glomerular filtration rate (eGFR) was calculated and followed up at 1 y after treatment. RESULTS: The diagnosis of PA was confirmed in 330 patients. Among them 17% of these patients had kidney impairment (eGFR<60ml/min/1.73 m(2)). Patients with PA had a higher prevalence of estimated hyperfiltration than those with essential hypertension (EH) (14.5 % vs. 7.0 %, p=0.005). The eGFR independently predicted PA (OR, 1.017) in the propensity-adjusted multivariate logistic model. In PA, plasma renin activity and lower serum potassium (p=0.018) was correlated with kidney impairment (p=0.001), while this relationship was not significant in patients with EH. Either unilateral adrenalectomy or treatment of spironolactone for PA patients caused a decrease of eGFR (p<0.001). Pre-operative hypokalemia (p=0.013) and long latency of hypertension (p=0.016) could enhance the significant decrease of eGFR after adrenalectomy. CONCLUSIONS: Patients with aldosteronism had relative estimated hyperfiltration than patients with EH. Calculation of eGFR may increase the specificity in identifying patients with PA. Our findings demonstrate the correlation of serum potassium and renin with estimated hyperfiltration in PA and their relationship to kidney damage. These results provide a high priority for future renal protective strategies and methods for the early diagnosis and prompt treatment of PA.
Vin-Cent Wu; Shao-Yu Yang; Jou-Wei Lin; Bor-Wen Cheng; Chin-Chi Kuo; Chia-Ti Tsai; Tzong-Shinn Chu; Kuo-How Huang; Shuo-Meng Wang; Yen-Hung Lin; Chih-Kang Chiang; Hung-Wei Chang; Chien-Yu Lin; Lian-Yu Lin; Jainn-Shiun Chiu; Fu-Chang Hu; Shih-Chieh Chueh; Yi-Luwn Ho; Kao-Lang Liu; Shuei-Liong Lin; Ruoh-Fang Yen; Kwan-Dun Wu; On Behalf Of The Taipai Studygroup
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-20
Journal Detail:
Title:  Clinica chimica acta; international journal of clinical chemistry     Volume:  -     ISSN:  1873-3492     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302422     Medline TA:  Clin Chim Acta     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010. Published by Elsevier B.V.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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