Prediction of long-term biochemical cure in patients with unilateral primary hyperaldosteronism treated surgically based on the early post-operative plasma aldosterone value

Endocrine journal

article

Yuki Ishihara¹  Hironobu Umakoshi²  Hiroki Kaneko¹  Kazutaka Nanba¹  Mika Tsuiki¹  Toru Kusakabe²  Noriko Satoh-Asahara²  Akihiro Yasoda²  Tetsuya Tagami¹ 

[1] Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center;Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center;Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University

关键词: Primary aldosteronism;    Aldosterone;    Biochemical outcome;    Surgical outcome;   

DOI  :  10.1507/endocrj.EJ21-0430

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

In 2017, the Primary Aldosteronism Surgical Outcome (PASO) investigators proposed consensus criteria for clinical and biochemical outcomes. However, 6 to 12 months need to pass in order to assess for the outcome in patients who have undergone surgery for the management of primary hyperaldosteronism. This study aims to evaluate the post-operative biochemical and clinical outcomes of primary aldosteronism (PA) on the basis of the laboratory findings obtained within 10 days after surgery. We retrospectively studied 59 consecutive patients with unilateral PA who underwent adrenalectomy and were assessed for plasma aldosterone concentration (PAC) and plasma renin activity both at the initial assessment (1–10 days after surgery) and the final assessment (6–12 months after surgery). When comparing the complete biochemical success group (n = 51) and the partial or absent biochemical success group (n = 8), the median post-operative PAC at the initial assessment was significantly greater in the partial or absent biochemical success group (12.7 ng/dL; interquartile range [IQR], 10.6–14.5) than that in the complete biochemical success group (6.3 ng/dL; IQR, 5.0–7.9) (p < 0.001), while no significant differences were observed in other factors. The receiver operating characteristic curves of post-operative PAC at the initial assessment, which was used to predict biochemical outcomes, indicated that 8.1 ng/dL is the optimal PAC cut-off for biochemical success (sensitivity, 76.5%; specificity, 100%). Low post-operative PAC at the initial assessment may predict the biochemical cure of PA.

【 授权许可】

Unknown