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BMC Endocrine Disorders

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Open Access 01-12-2021 | Adrenalectomy | Research article

Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas

Authors: Fang Sun, Yangning Hong, Hexuan Zhang, Xiaoli Liu, Zhigang Zhao, Hongbo He, Zhencheng Yan, Zhiming Zhu

Published in: BMC Endocrine Disorders | Issue 1/2021

Abstract

Background

Primary aldosteronism (PA) is highly prevalent in hypertensive population. Adrenal vein sampling (AVS) is the only procedure to assess adrenal aldosterone hypersecretion in PA. PA patients without aldosterone-producing adenomas (APA) frequently have unilateral aldosterone hypersecretion (UAH). These patients could bear inappropriate adrenalectomy without AVS. This study aims to identify which clinical characteristics should be recommended to perform AVS in these PA patients.

Methods

This study was performed from January 2018 to July 2019 at a center for hypertension and metabolic diseases. Adrenal computed tomography (CT) scan, biochemical evaluation, and AVS were performed.

Results

Total 141 patients were included in this study. Aldosterone to renin ratio (ARR) after confirmatory test is highly associated with adrenal laterality. The specificity of ARR > 10 (ng/dL)/(mU/L) after confirmatory test is 100%. After confirmatory test, patients with ARR > 10 (ng/dL)/(mU/L) had higher plasma aldosterone concentration and incidences of ischemic heart diseases and renal damage(p < 0.05).

Conclusions

After confirmatory tests, ARR > 10 (ng/dL)/(mU/L) indicates adrenal laterality, with increasingly cardiorenal damage in PA patients without APA. Thus, AVS should be recommended in these patients before surgery.

Trial registration

NCT03398785, Date of Registration: December 24, 2017.

Available only for authorised users

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Title: Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas
Authors: Fang Sun
Yangning Hong
Hexuan Zhang
Xiaoli Liu
Zhigang Zhao
Hongbo He
Zhencheng Yan
Zhiming Zhu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Adrenalectomy
Adrenalectomy
Published in: BMC Endocrine Disorders / Issue 1/2021
Electronic ISSN: 1472-6823
DOI: https://doi.org/10.1186/s12902-021-00770-1

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Determination of adrenal hypersecretion in primary Aldosteronism without aldosterone-production adenomas

Abstract

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Methods

Results

Conclusions

Trial registration

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