https://scholars.lib.ntu.edu.tw/handle/123456789/589966
標題: | Taiwan mini-frontier of primary aldosteronism: Updating treatment and comorbidities detection | 作者: | CHIEH-KAI CHAN Chang, Yi-Yao Tsai, Yi-Chun ZHENG-WEI CHEN Wu, Chun-Yi Huang, Wei-Chieh Yen, I-Weng Wu, Kuo-Hsin VIN-CENT WU YEN-HUNG LIN SHUO-MENG WANG Wang W.-J. Wu C.-H. Hu Y.-H. Er L.K. Chang C.-H. Tsai Y.-C. Yu C.-C. LIAN-YU LIN Hu F.-C. CHIN-CHEN CHANG KAO-LANG LIU Wang S.-M. KUO-HOW HUANG SHIH-CHIEH CHUEH SHIH-CHENG LIAO CHING-CHU LU RUOH-FANG YEN KWAN-DUN WU TAIPAI Study Group |
關鍵字: | Comorbidities detection; Frontier; Primary aldosteronism; Treatment | 公開日期: | 十月-2021 | 卷: | 120 | 期: | 10 | 來源出版物: | Journal of the Formosan Medical Association = Taiwan yi zhi | 摘要: | The aim of this study was to update the information on internationally acceptable standards and clinical practice recommendations for the management of patients with primary aldosteronism (PA). The Taiwan Society of Aldosteronism (TSA) Task Force acknowledged the novel issues of PA and reached a group consensus on PA in Taiwan by collecting the best available evidence and conducting one group meeting, several conference calls, and multiple e-mail communications. Unilateral adrenalectomy is the preferred treatment for patients with aldosterone-producing adenoma (APA). For medical treatment with mineralocorticoid receptor antagonists (MRAs), spironolactone is the first-line treatment, and eplerenone is a reasonable alternative in PA patients intolerant or contraindicated to spironolactone. The dose of MRAs can be titrated according to plasma renin activity (PRA). For screening PA-related comorbidities, we suggest albuminuria to predict a post-treatment decline in renal function, echocardiography as cardiac evaluation, bone mineral density scan for osteoporosis, and obstructive sleep apnea. In tissue and genetic surveys, we suggest immunohistochemical staining and somatic mutation screening for post-operative adrenal specimens in APA patients. With this consensus, we hope to update the information on PA for clinical physicians to facilitate better identification, management and treatment of patients with PA. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/589966 | ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2021.03.032 | SDG/關鍵字: | eplerenone; mineralocorticoid antagonist; spironolactone; spironolactone; adrenalectomy; albuminuria; bone density; comorbidity; consensus; controlled study; e-mail; echocardiography; health survey; human; immunohistochemistry; kidney function; osteoporosis; physician; plasma renin activity; postoperative care; practice guideline; primary hyperaldosteronism; Review; sleep disordered breathing; somatic mutation; Taiwan; treatment outcome; hyperaldosteronism; hypertension; Adrenalectomy; Humans; Hyperaldosteronism; Hypertension; Mineralocorticoid Receptor Antagonists; Spironolactone; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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