Taiwan mini-frontier of primary aldosteronism: Updating treatment and comorbidities detection
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
Journal Volume
120
Journal Issue
10
Pages
1811–1820
Date Issued
2021-10
Author(s)
Chang, Yi-Yao
Tsai, Yi-Chun
Wu, Chun-Yi
Huang, Wei-Chieh
Wu, Kuo-Hsin
Wang W.-J.
Wu C.-H.
Hu Y.-H.
Er L.K.
Chang C.-H.
Tsai Y.-C.
Yu C.-C.
Hu F.-C.
Wang S.-M.
TAIPAI Study Group
Abstract
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.
Subjects
Comorbidities detection; Frontier; Primary aldosteronism; Treatment
SDGs
Other Subjects
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
Type
review