| Role of unilateral adrenalectomy in bilateral primary aldosteronism: a 22-year single center experience. | |
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MedLine Citation:
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PMID: 19401369 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of the study was to examine blood pressure and biochemical responses to unilateral adrenalectomy in patients with bilateral primary aldosteronism (PA) and identify predictive parameters. CONTEXT: PA considered due to bilateral autonomous production of aldosterone is usually treated medically. Unilateral adrenalectomy has been considered ineffective. Because quality outcome data are lacking and medical treatment may cause adverse effects or fail to control hypertension, defining the role for unilateral adrenalectomy in bilateral PA is an important clinical issue. DESIGN AND SETTING: Between 1984 and 2004, 51 of 684 patients diagnosed with bilateral PA underwent unilateral adrenalectomy. This report is based on the records of the 40 considered suitable for inclusion, who were followed for at least 12 (median, 56.4) months. RESULTS: Hypertension was cured in 15% of patients and improved in 20%, usually within 1 yr of unilateral adrenalectomy. The proportion with controlled hypertension was significantly (P < 0.001) higher after adrenalectomy (65%) than before (25%). Mean systolic (P < 0.001) and diastolic (P < 0.001) blood pressure, left ventricular mass index (P < 0.05), plasma upright aldosterone (P < 0.05), and aldosterone/renin ratio (P < 0.001) fell. Serum creatinine independently predicted hypertension cure. CONCLUSION: Although this retrospective analysis of patients from a single center does not permit prediction of response rates among patients diagnosed elsewhere, it suggests that unilateral adrenalectomy can be beneficial in some patients with apparent bilateral PA and should not be dismissed as a treatment option. |
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Authors:
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Norlela Sukor; Richard D Gordon; Yee Kim Ku; Mark Jones; Michael Stowasser |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2009-04-28 |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: 94 ISSN: 1945-7197 ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-08 Completed Date: 2009-08-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: 2437-45 Citation Subset: AIM; IM |
Affiliation:
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Endocrine Hypertension Research Center, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenalectomy
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methods* Adult Aged Aldosterone / blood Blood Pressure / physiology Cohort Studies Female Follow-Up Studies Heart Ventricles / pathology Humans Hyperaldosteronism / blood, pathology, surgery* Male Middle Aged Organ Size Retrospective Studies Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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52-39-1/Aldosterone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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