國家衛生研究院 NHRI:Item 3990099045/11918
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    题名: Adrenalectomy Improves the long-term risk of end-stage renal disease and mortality of primary aldosteronism
    作者: Chen, YY;Lin, YH;Huang, WC;Chueh, E;Chen, L;Yang, SY;Lin, PC;Lin, LY;Lin, YH;Wu, VC;Chu, TS;Wu, KD
    贡献者: Institute of Population Health Sciences
    摘要: 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.
    日期: 2019-06-01
    關聯: 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
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