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Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas
BACKGROUND: Primary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosterone-producing adenomas (APA) frequently have unilateral aldosterone hypersecretion...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167985/ https://www.ncbi.nlm.nih.gov/pubmed/34059026 http://dx.doi.org/10.1186/s12902-021-00770-1 |
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author | Sun, Fang Hong, Yangning Zhang, Hexuan Liu, Xiaoli Zhao, Zhigang He, Hongbo Yan, Zhencheng Zhu, Zhiming |
author_facet | Sun, Fang Hong, Yangning Zhang, Hexuan Liu, Xiaoli Zhao, Zhigang He, Hongbo Yan, Zhencheng Zhu, Zhiming |
author_sort | Sun, Fang |
collection | PubMed |
description | BACKGROUND: Primary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosterone-producing adenomas (APA) frequently have unilateral aldosterone hypersecretion (UAH). These patients could bear inappropriate adrenalectomy without AVS. This study aims to identify which clinical characteristics should be recommended to perform AVS in these PA patients. METHODS: This study was performed from January 2018 to July 2019 at a center for hypertension and metabolic diseases. Adrenal computed tomography (CT) scan, biochemical evaluation, and AVS were performed. RESULTS: Total 141 patients were included in this study. Aldosterone to renin ratio (ARR) after confirmatory test is highly associated with adrenal laterality. The specificity of ARR > 10 (ng/dL)/(mU/L) after confirmatory test is 100%. After confirmatory test, patients with ARR > 10 (ng/dL)/(mU/L) had higher plasma aldosterone concentration and incidences of ischemic heart diseases and renal damage(p < 0.05). CONCLUSIONS: After confirmatory tests, ARR > 10 (ng/dL)/(mU/L) indicates adrenal laterality, with increasingly cardiorenal damage in PA patients without APA. Thus, AVS should be recommended in these patients before surgery. TRIAL REGISTRATION: NCT03398785, Date of Registration: December 24, 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12902-021-00770-1. |
format | Online Article Text |
id | pubmed-8167985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81679852021-06-02 Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas Sun, Fang Hong, Yangning Zhang, Hexuan Liu, Xiaoli Zhao, Zhigang He, Hongbo Yan, Zhencheng Zhu, Zhiming BMC Endocr Disord Research Article BACKGROUND: Primary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosterone-producing adenomas (APA) frequently have unilateral aldosterone hypersecretion (UAH). These patients could bear inappropriate adrenalectomy without AVS. This study aims to identify which clinical characteristics should be recommended to perform AVS in these PA patients. METHODS: This study was performed from January 2018 to July 2019 at a center for hypertension and metabolic diseases. Adrenal computed tomography (CT) scan, biochemical evaluation, and AVS were performed. RESULTS: Total 141 patients were included in this study. Aldosterone to renin ratio (ARR) after confirmatory test is highly associated with adrenal laterality. The specificity of ARR > 10 (ng/dL)/(mU/L) after confirmatory test is 100%. After confirmatory test, patients with ARR > 10 (ng/dL)/(mU/L) had higher plasma aldosterone concentration and incidences of ischemic heart diseases and renal damage(p < 0.05). CONCLUSIONS: After confirmatory tests, ARR > 10 (ng/dL)/(mU/L) indicates adrenal laterality, with increasingly cardiorenal damage in PA patients without APA. Thus, AVS should be recommended in these patients before surgery. TRIAL REGISTRATION: NCT03398785, Date of Registration: December 24, 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12902-021-00770-1. BioMed Central 2021-05-31 /pmc/articles/PMC8167985/ /pubmed/34059026 http://dx.doi.org/10.1186/s12902-021-00770-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Sun, Fang Hong, Yangning Zhang, Hexuan Liu, Xiaoli Zhao, Zhigang He, Hongbo Yan, Zhencheng Zhu, Zhiming Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title | Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title_full | Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title_fullStr | Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title_full_unstemmed | Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title_short | Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas |
title_sort | determination of adrenal hypersecretion in primary aldosteronism without aldosterone-production adenomas |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167985/ https://www.ncbi.nlm.nih.gov/pubmed/34059026 http://dx.doi.org/10.1186/s12902-021-00770-1 |
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