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Transtubular potassium gradient predicts kidney function impairment after adrenalectomy in primary aldosteronism
- Source :
- Therapeutic Advances in Chronic Disease, Therapeutic Advances in Chronic Disease, Vol 11 (2020)
- Publication Year :
- 2020
-
Abstract
- Background: In primary aldosteronism (PA), kidney function impairment could be concealed by relative hyperfiltration and emerge after adrenalectomy. We hypothesized transtubular gradient potassium gradient (TTKG), a kidney aldosterone bioactivity indicator, could correlate to end organ damage and forecast kidney function impairment after adrenalectomy. Methods: In the present prospective study, we enrolled lateralized PA patients who underwent adrenalectomy and were followed up 12 months after operation in the Taiwan Primary Aldosteronism Investigation (TAIPAI) registry from 2010 to 2018. The clinical outcome was kidney function impairment, defined as estimated glomerular filtration rate (eGFR) 2 at 12 months after adrenalectomy. End organ damage is determined by microalbuminuria and left ventricular mass. Results: In total, 323 patients [mean, 50.8 ± 10.9 years old; female 178 (55.1%)] were enrolled. Comparing pre-operation and post-operation data, systolic blood pressure, serum aldosterone, urinary albumin to creatinine ratio and eGFR decreased. TTKG ⩾ 4.9 correlated with pre-operative urinary albumin to creatinine ratio >50 mg/g [odds ratio (OR) = 2.42; p = 0.034] and left ventricular mass (B = 20.10; p = 0.018). Multivariate logistic regression analysis demonstrated that TTKG ⩾ 4.9 could predict concealed chronic kidney disease (OR = 5.42; p = 0.011) and clinical success (OR = 2.90, p = 0.017) at 12 months after adrenalectomy. Conclusions: TTKG could predict concealed kidney function impairment and cure of hypertension in PA patients after adrenalectomy. TTKG more than 4.9 as an adverse surrogate of aldosterone and hypokalaemia correlated with pre-operative end organ damage in terms of high proteinuria and cardiac hypertrophy.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Potassium
Urology
Medicine (miscellaneous)
Renal function
chemistry.chemical_element
030204 cardiovascular system & hematology
03 medical and health sciences
transtubular potassium gradient
0302 clinical medicine
Primary aldosteronism
medicine
Original Research
primary aldosteronism
business.industry
Adrenalectomy
lcsh:RM1-950
adrenalectomy
Transtubular potassium gradient
medicine.disease
lcsh:Therapeutics. Pharmacology
030104 developmental biology
kidney function impairment
chemistry
business
Subjects
Details
- ISSN :
- 20406223
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Therapeutic advances in chronic disease
- Accession number :
- edsair.doi.dedup.....e134e84091faf9b1c365a6fbdd2753ef