KLI

Contralateral Suppression at Adrenal Venous Sampling Is Associated with Renal Impairment Following Adrenalectomy for Unilateral Primary Aldosteronism

Metadata Downloads
Abstract
Background: Adrenal venous sampling (AVS) is performed to distinguish the subtype of primary aldosteronism (PA). The clinical implication of contralateral suppression (CS; aldosterone/cortisol(nondominant)
Methods: In this retrospective observational multi-center study, we analyzed PA patients who underwent both successful adrenocorticotropin hormone-stimulated AVS and unilateral adrenalectomy. Successful cannulation was defined as the selectivity index (cortisol(adrenal)/cortisol(peripheral)) >= 3. Clinical and biochemical outcomes after unilateral adrenalectomy were evaluated based on the international Primary Aldosteronism Surgical Outcome consensus.

Results: Among 263 patients analyzed, 247 had CS (93.9%). Patients with CS had lower serum potassium levels, higher plasma aldosterone concentration, higher aldosterone-to-renin ratio (ARR), and larger adenoma size than those without CS. Those with CS showed significantly higher lateralization index than those without CS (P<0.001). Although postoperative blood pressure and ARR significantly decreased in those with CS, clinical and biochemical outcomes were comparable in both groups. When the cut-off value of age was determined using receiver operating characteristic (ROC) analysis, patients aged >= 50 years old with contralateral suppression index (CSI; the ratio between aldosterone/cortisol(nondominant) and aldosterone/cortisol(peripheral)) <= 0.26 had greater odds ratio (6.43; 95% confidence interval, 1.30 to 31.69) of incident chronic kidney disease than those aged <50 years with CSI >0.26 after adjusting for other factors.

Conclusion: CS may not predict postoperative clinical and biochemical outcomes in subjects with unilateral aldosterone excess, but it is associated with postsurgical deterioration of renal function in subjects over 50 years with CSI <= 0.26.
Author(s)
고정민김상완김재현김정희유지희이동화이승훈홍아람Jung Hyun LeeSeo Young LeeYe Seul Yang
Issued Date
2021
Type
Article
Keyword
AdrenalectomyGlomerular filtration rateHyperaldosteronismHypertensionPhlebographyTreatment outcome
DOI
10.3803/EnM.2021.1047
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8107
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_kiss_primary_3900118&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Contralateral%20Suppression%20at%20Adrenal%20Venous%20Sampling%20Is%20Associated%20with%20Renal%20Impairment%20Following%20Adrenalectomy%20for%20Unilateral%20Primary%20Aldosteronism&amp;offset=0&amp;pcAvailability=true
Publisher
ENDOCRINOLOGY AND METABOLISM
Location
대한민국
Language
영어
ISSN
2093-596X
Citation Volume
36
Citation Number
4
Citation Start Page
875
Citation End Page
884
Appears in Collections:
Medicine > Medicine
Authorize & License
  • Authorize공개
Files in This Item:
  • There are no files associated with this item.

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.