Taiwan mini-frontier of primary aldosteronism: Updating treatment and comorbidities detection

Chan, Chieh‐Kai; Chang, Yuan‐Jen; Tsai, Yi‐Chun; Chen, Zheng-Wei; Wu, Chunyi; Huang, Wei‐Chieh; Yen, I-Weng; Wu, Kuo-Hsin; Wu, Vin‐Cent; Lin, Yen‐Hung; Lin, Jui-Hsiang; Wang, Weijie; Wu, Che‐Hsiung; Hu, Yahui; Er, Leay Kiaw; Chang, Chia‐Hui; Tsai, Yao‐Chou; Yu, Chih-Chin; Lin, Lian‐Yu; Hu, Fu‐Chang; Chang, Chin‐Chen; Liu, Kao–Lang; Wang, Shuo-Meng; Huang, Kuo‐How; Chueh, Shih-Chieh; Liao, Shih‐Cheng; Lu, Ching‐Chu; Yen, Ruoh‐Fang; Wu, Kwan‐Dun

doi:10.1016/j.jfma.2021.03.032

Cited by 6 publications

(2 citation statements)

References 88 publications

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“…Our study provides clinical implications. Several expert panels suggest that posttreatment PRA is a potential target parameter for MRA titration and reversing renin suppression (ie, ≥1.0 ng/mL per hour) could be a cornerstone of an optimal medical treatment for PA. 1,2,39 These perspectives are based on 4 previous studies, [9][10][11]13 including 2 studies indicating that medically treated patients with PA with posttreatment PRA of ≥1.0 ng/mL per hour potentially have lower incidence risks of CVD, atrial fibrillation, and death compared with those with posttreatment PRA of <1.0 ng/mL per hour. 9,10 The other 2 studies evaluated the association of posttreatment renin status with renal outcomes; however, these studies did not reveal the preferable renal outcomes for medically treated patients with PA with posttreatment PRA ≥1.0 ng/mL per hour than those with posttreatment PRA <1.0 ng/mL per hour.…”

Section: Original Articlementioning

confidence: 99%

Association of Reversal of Renin Suppression With Long-Term Renal Outcome in Medically Treated Primary Aldosteronism

et al. 2023

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Background: Renin suppression in primary aldosteronism indicates mineralocorticoid receptor activation via excessive aldosterone secretion, inducing renal damage. We investigated whether the reversal of renin suppression after the initiation of mineralocorticoid receptor antagonist therapy was associated with long-term renal outcomes in medically treated patients with primary aldosteronism. Methods: This retrospective cohort study included 318 patients with primary aldosteronism treated with mineralocorticoid receptor antagonist between 2008 and 2020 at the Yokohama Rosai Hospital in Japan. The posttreatment renin status was defined as unsuppressed (ie, reversal of renin suppression) when individual plasma renin activity after the initiation of mineralocorticoid receptor antagonist (post-plasma renin activity) was ≥1.0 ng/(mL h); otherwise, it was defined as suppressed. We analyzed the association of posttreatment renin status with subsequent longitudinal estimated glomerular filtration rate changes using linear mixed-effects models for repeated measurements, adjusting for potential confounders. Results: The posttreatment renin status of 119 patients was unsuppressed (median post-plasma renin activity, 1.7 ng/[mL h]) and that of 199 patients was suppressed (median post-PRA, 0.5 ng/[mL h]). Through the median follow-up period of 3.1 years, the decline in estimated glomerular filtration rate was milder among patients with the unsuppressed posttreatment renin (−0.46 [95% CI, −0.63 to −0.28] mL/min per 1.73 m 2 per year) than those with suppressed posttreatment renin (−1.41 [95% CI, −1.56 to −1.27] mL/min per 1.73 m 2 per year; difference, 0.96 [95% CI, 0.72–1.20] mL/min per 1.73 m 2 per year). Conclusions: Our findings may highlight the importance of reversing renin suppression with optimal mineralocorticoid receptor antagonist titration in medically treated primary aldosteronism, which could mitigate adverse renal outcomes.

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Section: Original Articlementioning

confidence: 99%

Association of Reversal of Renin Suppression With Long-Term Renal Outcome in Medically Treated Primary Aldosteronism

et al. 2023

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“…Primary aldosteronism (PA) is a genetic condition with continuous, autonomous excessive production of aldosterone and is the most common cause of secondary hypertension. The excess aldosterone causes mineralocorticoid hypertension (14). There have been courses of normotensive pregnancies followed by postpartum hypertension, further diagnosed as PA (15).…”

Section: Primary Hyperaldosteronismmentioning

confidence: 99%

Cushing Syndrome in Pregnancy: A Case Presentation and Review of Literature

Samimagham

Ziaei

Tamaddondar

et al. 2023

J Kermanshah Univ Med Sci

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: The Cushing syndrome typically presents with abdominal obesity, wide purple striae, glucose intolerance, hypertension, easy bruising, and muscle weakness, a rare disorder interfering with ovulation, making the combination of Cushing syndrome and pregnancy less common. Nevertheless, Cushing syndrome has been reported in pregnancy. Here we report another case of pregnancy with Cushing syndrome, which presents merely with obesity, hypertension, and glucose intolerance, using a literature review at the end.

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Association of urinary liver-type fatty acid–binding protein with outcomes after adrenalectomy for unilateral primary aldosteronism

Chen

et al. 2023

Clinica Chimica Acta

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Taiwan mini-frontier of primary aldosteronism: Updating treatment and comorbidities detection

Cited by 6 publications

References 88 publications

Association of Reversal of Renin Suppression With Long-Term Renal Outcome in Medically Treated Primary Aldosteronism

Association of Reversal of Renin Suppression With Long-Term Renal Outcome in Medically Treated Primary Aldosteronism

Cushing Syndrome in Pregnancy: A Case Presentation and Review of Literature

Association of urinary liver-type fatty acid–binding protein with outcomes after adrenalectomy for unilateral primary aldosteronism

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