Comorbidities in Primary Aldosteronism

Quinkler, Marcus; Born-Frontsberg, Eric; Fourkiotis, Verena

doi:10.1055/s-0029-1243257

Cited by 41 publications

(33 citation statements)

References 53 publications

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“…Patients with PA have an increased risk of developing relevant comortalities and comorbidities, e.g. vascular, cardiac or cerebrovascular morbidities, and renal insufficiency (2,6,7,8). On the basis of the German Conn's Registry, we have discovered a positive correlation between aldosterone levels and the prevalence of the most common comorbidities, including the prevalence of chronic renal failure (2).…”

Section: Introductionmentioning

confidence: 92%

Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism

Fourkiotis

Vonend²,

Diederich³

et al. 2013

European Journal of Endocrinology

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Objective: Primary aldosteronism (PA) has deleterious effects on kidney function independent of blood pressure levels. Up to now, data on effectiveness of different PA therapies regarding renal function are scarce. Design and methods: This prospective multi-center study included 29 patients with newly diagnosed PA evaluated before and 1 year after treatment initiation, and a second cohort including 119 patients who were evaluated 5.3 and 6.8 years after treatment initiation. Glomerular filtration rate (GFR), spot urine albumin excretion/urinary creatinine (UAE/Ucrea) ratio, biochemical parameters, and 24-h blood pressure were measured. In a larger cross-sectional cohort, renal function was evaluated depending on the type of treatment (adrenalectomy (ADX; nZ86); spironolactone (nZ65); and eplerenone (nZ18)). Results: GFR and UAE/Ucrea ratio significantly decreased in newly diagnosed PA patients after treatment initiation. In the second cohort, GFR and UAE/Ucrea ratio did not change during study period, and blood pressure was well controlled. In the larger cross-sectional cohort, no differences were seen in GFR and UAE/Ucrea ratio between PA patients on different treatment regimens. However, eplerenone treatment showed lower potassium levels and higher number of required antihypertensive medications. Conclusions: Renal dysfunction with elevated albuminuria was seen in PA patients and was reversible after treatment initiation. Medical therapies with spironolactone or eplerenone seem to be as effective as ADX regarding renal function and blood pressure; however, sufficient daily doses need to be given.

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Section: Introductionmentioning

confidence: 92%

Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism

Fourkiotis

Vonend²,

Diederich³

et al. 2013

European Journal of Endocrinology

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show abstract

“…Patients with PA have an increased risk of developing relevant comorbidities, e.g. vascular, cardiac, or cerebrovascular morbidities and renal insufficiency compared with other hypertensive patients (2,3,4,5,6,7). Therefore, it seems mandatory to detect early patients with PA.…”

Section: Introductionmentioning

confidence: 99%

Post-saline infusion test aldosterone levels indicate severity and outcome in primary aldosteronism

Weigel

Riester

Hanslik

et al. 2015

European Journal of Endocrinology

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Objective: The saline infusion test (SIT) is widely used as a confirmatory test for primary aldosteronism (PA). SIT results are judged as follows: post-test aldosterone levels !50 ng/l exclude PA, whereas levels O50 ng/l confirm PA. We hypothesized that post-SIT aldosterone concentrations indicate the severity of PA and might predict outcome. Design: The study includes 256 PA patients of the German Conn's Registry who prospectively underwent SIT. The data of 126 patients with complete follow-up of 1.2G0.3 years after diagnosis were analyzed. The patients were divided into two groups with post-SIT aldosterone levels of 50-100 ng/l (group 1; nZ38) and of O100 ng/l (group 2; nZ88). Results: Patients in group 2 had a significantly shorter duration of hypertension (7.5 vs 11.7 years (median), PZ0.014), higher systolic blood pressure (BP; 151G16 vs 143G17 mmHg, PZ0.036), lower serum potassium (3.3G0.6 vs 3.5G0.4 mmol/l, PZ0.006), higher 24-h urine protein excretion (7.4 vs 5.4 mg/dl (median), PZ0.012), and were more often female (PZ0.038). They showed more often unilateral disease (P!0.005) with larger tumors (14G10 vs 7G10 mm, PZ0.021), underwent more often adrenalectomy (75% vs 37%, P!0.005), required a lower number of antihypertensive drugs after adrenalectomy (1.2G1.2 vs 2.5G1.4, PZ0.001), had a faster normalization of urinary protein excretion (with medical treatment PZ0.049; with Adx P!0.005) at follow-up, and more frequently underlying well-characterized mutation (PZ0.047). Conclusions: PA patients with post-SIT aldosterone levels of O100 ng/l have a more rapid development of PA caused more frequently by unilateral disease with larger aldosterone-producing adenomas. However, this group of patients may have a significantly better outcome following specific treatment.

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“…Increased cardiovascular complications have been observed in PHA patients [5][6][7][8][9][10][11]. As compared to patients with essential hypertension, those with either IHA or APA had increased occurrence of cardiovascular events independent of blood pressure [8].…”

mentioning

confidence: 99%

Female sex hormones are associated with the reduction of serum sodium and hypertension complications in patients with aldosterone-producing adenoma

et al. 2013

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Comorbidities in Primary Aldosteronism

Cited by 41 publications

References 53 publications

Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism

Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism

Post-saline infusion test aldosterone levels indicate severity and outcome in primary aldosteronism

Female sex hormones are associated with the reduction of serum sodium and hypertension complications in patients with aldosterone-producing adenoma

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