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Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism?
PURPOSE: This study was conducted to investigate the predictors of kidney outcome after laparoscopic adrenalectomy in patients with primary aldosteronism (PA). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 74 patients who underwent unilateral adrenalectomy for the treatme...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Urological Association
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421995/ https://www.ncbi.nlm.nih.gov/pubmed/34387032 http://dx.doi.org/10.4111/icu.20200582 |
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author | Yoon, Jee Hee Chung, Ho Seok Hong, A Ram Kim, Hee Kyung Kang, Ho-Cheol Kim, Myung Soo Hwang, Eu Chang Jung, Seung Il Park, Kwangsung Kwon, Dongdeuk |
author_facet | Yoon, Jee Hee Chung, Ho Seok Hong, A Ram Kim, Hee Kyung Kang, Ho-Cheol Kim, Myung Soo Hwang, Eu Chang Jung, Seung Il Park, Kwangsung Kwon, Dongdeuk |
author_sort | Yoon, Jee Hee |
collection | PubMed |
description | PURPOSE: This study was conducted to investigate the predictors of kidney outcome after laparoscopic adrenalectomy in patients with primary aldosteronism (PA). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 74 patients who underwent unilateral adrenalectomy for the treatment of PA from January 2011 to December 2019. Patient characteristics and serial data on postoperative changes in kidney function were analyzed and compared between the two groups according to the presence of acute kidney injury (AKI). Postoperative AKI was defined as a decline in the estimated glomerular filtration rate (eGFR) of >50% or an increase in the serum creatinine level of ≥0.3 mg/dL at 1 week after surgery compared with perioperative levels. Chronic kidney disease (CKD) was defined as an eGFR < 60 mL/min/1.73 m(2) present for 3 months. RESULTS: Nineteen patients (25.7%) had postoperative AKI. Patients who experienced postoperative AKI had higher aldosterone-to-renin ratios, higher rates of dyslipidemia, and more left ventricular hypertrophy than did patients without postoperative AKI (p=0.015, 0.036, and 0.033, respectively). Twenty-eight patients (37.8%) had CKD at 6 months after surgery, including 15 patients who had newly progressed to CKD postoperatively. In the multivariate regression analysis of patients without preoperative CKD, the only independent predictor of the progression to CKD was preoperative albuminuria (p=0.007). CONCLUSIONS: In this study, one-quarter of the patients had postoperative AKI after unilateral adrenalectomy for the treatment of PA. However, postoperative AKI was not directly correlated with CKD progression. Preoperative albuminuria was an independent predictor of the progression of CKD. |
format | Online Article Text |
id | pubmed-8421995 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Urological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-84219952021-09-16 Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? Yoon, Jee Hee Chung, Ho Seok Hong, A Ram Kim, Hee Kyung Kang, Ho-Cheol Kim, Myung Soo Hwang, Eu Chang Jung, Seung Il Park, Kwangsung Kwon, Dongdeuk Investig Clin Urol Original Article PURPOSE: This study was conducted to investigate the predictors of kidney outcome after laparoscopic adrenalectomy in patients with primary aldosteronism (PA). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 74 patients who underwent unilateral adrenalectomy for the treatment of PA from January 2011 to December 2019. Patient characteristics and serial data on postoperative changes in kidney function were analyzed and compared between the two groups according to the presence of acute kidney injury (AKI). Postoperative AKI was defined as a decline in the estimated glomerular filtration rate (eGFR) of >50% or an increase in the serum creatinine level of ≥0.3 mg/dL at 1 week after surgery compared with perioperative levels. Chronic kidney disease (CKD) was defined as an eGFR < 60 mL/min/1.73 m(2) present for 3 months. RESULTS: Nineteen patients (25.7%) had postoperative AKI. Patients who experienced postoperative AKI had higher aldosterone-to-renin ratios, higher rates of dyslipidemia, and more left ventricular hypertrophy than did patients without postoperative AKI (p=0.015, 0.036, and 0.033, respectively). Twenty-eight patients (37.8%) had CKD at 6 months after surgery, including 15 patients who had newly progressed to CKD postoperatively. In the multivariate regression analysis of patients without preoperative CKD, the only independent predictor of the progression to CKD was preoperative albuminuria (p=0.007). CONCLUSIONS: In this study, one-quarter of the patients had postoperative AKI after unilateral adrenalectomy for the treatment of PA. However, postoperative AKI was not directly correlated with CKD progression. Preoperative albuminuria was an independent predictor of the progression of CKD. The Korean Urological Association 2021-09 2021-07-22 /pmc/articles/PMC8421995/ /pubmed/34387032 http://dx.doi.org/10.4111/icu.20200582 Text en © The Korean Urological Association, 2021 https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Yoon, Jee Hee Chung, Ho Seok Hong, A Ram Kim, Hee Kyung Kang, Ho-Cheol Kim, Myung Soo Hwang, Eu Chang Jung, Seung Il Park, Kwangsung Kwon, Dongdeuk Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title | Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title_full | Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title_fullStr | Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title_full_unstemmed | Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title_short | Is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
title_sort | is acute kidney injury after laparoscopic adrenalectomy related to the progression of chronic kidney disease in patients with primary aldosteronism? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421995/ https://www.ncbi.nlm.nih.gov/pubmed/34387032 http://dx.doi.org/10.4111/icu.20200582 |
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