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http://ir.nhri.org.tw/handle/3990099045/11918
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| Title: | Adrenalectomy Improves the long-term risk of end-stage renal disease and mortality of primary aldosteronism |
| Authors: | Chen, YY;Lin, YH;Huang, WC;Chueh, E;Chen, L;Yang, SY;Lin, PC;Lin, LY;Lin, YH;Wu, VC;Chu, TS;Wu, KD |
| Contributors: | Institute of Population Health Sciences |
| Abstract: | Objective: Primary aldosteronism (PA) is a common cause of secondary hypertension, and the long-term effect of excess aldosterone on kidney function is unknown. Patients and Methods: We used a longitudinal population database from the Taiwan National Health Insurance system and applied a validated algorithm to identify patients with PA diagnosed between 1997 and 2009. Results: There were 2699 patients with PA recruited, of whom 761 patients with an aldosterone-producing adenoma (APA) were identified. The incidence rate of end-stage renal disease (ESRD) was 3% in patients with PA after targeted treatments and 5.2 years of follow-up, which was comparable to the rate in controls with essential hypertension (EH). However, after taking mortality as a competing risk, we found a significantly lower incidence of ESRD when comparing patients with PA vs EH [subdistribution hazard ratio (sHR), 0.38; P = 0.007] and patients with APA vs EH (sHR 0.55; P = 0.021) after adrenalectomy; however, we did not see similar results in groups with mineralocorticoid receptor antagonist (MRA)treated PA vs EH. There was also a significantly lower incidence of mortality in groups with PA and APA who underwent adrenalectomy than among EH controls (P < 0.001). Conclusion: Regarding incident ESRD, patients with PA were comparable to their EH counterparts after treatment. After adrenalectomy, patients with APA had better long-term outcomes regarding progression to ESRD and mortality than hypertensive controls, but MRA treatments did not significantly affect outcome. |
| Date: | 2019-06-01 |
| Relation: | Journal of the Endocrine Society. 2019 Jun 1;3(6):1110-1126. |
| Link to: | http://dx.doi.org/10.1210/js.2019-00019 |
| Cited Times(Scopus): | https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85072294093 |
| Appears in Collections: | [陳麗光] 期刊論文
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