Clinical characteristics of primary aldosteronism from an analysis of 145 cases

Conn, Jerome W.; Knopf, Ralph F.; Nesbit, Reed M.

doi:10.1016/0002-9610(64)90252-1

Cited by 405 publications

(141 citation statements)

References 57 publications

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“…Although primary aldosteronism has long been considered a relatively benign form of hypertension (6,7), recent studies suggest that long-term exposure to high aldosterone levels might lead to cardiovascular (8) and renal (9) structural damage that seems to occur independent of the BP level. With respect to the kidney, animal studies support the role of aldosterone in the progression of renal vascular disease (10 -13), but the clinical evidence of the contribution of this hormone to renal dysfunction is limited (14 -16).…”

mentioning

confidence: 99%

“…With respect to the kidney, animal studies support the role of aldosterone in the progression of renal vascular disease (10 -13), but the clinical evidence of the contribution of this hormone to renal dysfunction is limited (14 -16). In fact, the majority of initial reports indicated that primary aldosteronism is less likely to cause overt renal damage (6,7,17,18), and two recent studies with short-term (19) and long-term (20) follow-up consistently demonstrated that the renal dysfunction of primary aldosteronism is closely related with the hemodynamic adaptation of the kidney to the effect of aldosterone excess.…”

mentioning

confidence: 99%

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Relationships of Plasma Renin Levels with Renal Function in Patients with Primary Aldosteronism

Catena¹,

Colussi²,

Nadalini³

et al. 2007

Clinical Journal of the American Society of Nephrology

102

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Background: The renal damage that is present in primary aldosteronism might reflect functional and potentially reversible abnormalities that are initiated by glomerular hyperfiltration. The aim of this study was to investigate the relationships of plasma renin and aldosterone concentrations with renal outcomes after treatment of primary aldosteronism.Design, setting, participants, and measurements: Fifty-six consecutive patients who had primary aldosteronism and were recruited in a university center were studied. Patients were prospectively followed after either surgical or medical treatment for a mean of 6.2 yr, during which they received antihypertensive drugs to reach a target BP of <140/90 mmHg.Results: At baseline, patients with primary aldosteronism had higher creatinine clearance and albuminuria than 323 patients with essential hypertension and 113 normotensive individuals. In patients with primary aldosteronism, plasma active renin levels that were higher than the lower limit of detection (2.5 pg/ml) were associated with higher BP, plasma potassium, and albuminuria and lower creatinine clearance. Plasma aldosterone concentrations that were higher than the median value (225 pg/ml) were associated with lower plasma potassium and higher creatinine clearance. Creatinine clearance was correlated directly with plasma aldosterone and inversely with renin. During follow-up, patients with higher baseline plasma renin required use of more antihypertensive drugs to obtain BP control and had a smaller early decline in albuminuria than did patients with suppressed renin.Conclusions: Escape of renin from suppression by excess aldosterone is associated with evidence of more severe renal damage in patients with primary aldosteronism and predicts less favorable outcomes after treatment.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Relationships of Plasma Renin Levels with Renal Function in Patients with Primary Aldosteronism

Catena¹,

Colussi²,

Nadalini³

et al. 2007

Clinical Journal of the American Society of Nephrology

102

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“…The link between aldosterone and hypertension has been evident since studies by Conn et al showed that hypertension was prevalent in a cohort of patients with primary aldosteronism (PA) [19]. Similarly, patients with glucocorticoid-remediable hypertension, and therefore raised plasma aldosterone, have an increased frequency of stroke and hypertension [20,21].…”

Section: Mineralocorticoids and Strokementioning

confidence: 99%

Aldosterone: good guy or bad guy in cerebrovascular disease?

Rigsby

Cannady

Dorrance

2005

Trends in Endocrinology & Metabolism

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Stroke is a leading cause of disability in the Western world, yet the choices for therapeutic intervention are few. The complex role played by aldosterone in the pathogenesis of stroke is beginning to emerge. Chronic mineralocorticoid receptor (MR) blockade reduces the incidence of hemorrhagic strokes and the severity of damage caused by ischemic strokes. This appears to be a vascular phenomenon because MR blockade increases vessel lumen diameter, which presumably increases blood flow and perfusion of the tissue to reduce ischemic damage. However, the vascular protection afforded by MR antagonism is at odds with the results seen within the brain, where MR activation is required for neuronal survival. Both of these divergent effects have possible therapeutic implications for stroke.

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“…Reports of PA associated with overt Cushing's syndrome however, are rare (6)(7)(8). Since abnormal glucose metabolism is frequently associated with PA (9) or preclinical Cushing's syndrome (10), the combination of the two conditions could be associated with the development of overt diabetes mellitus. Here, we report a case of overt diabetes mellitus in a patient with combined PA and Cushing's syndrome.…”

Section: Introductionmentioning

confidence: 99%