https://scholars.lib.ntu.edu.tw/handle/123456789/514402
標題: | Transtubular potassium gradient predicts kidney function impairment after adrenalectomy in primary aldosteronism | 作者: | Liao, Hung-Wei SHUO-MENG WANG CHIEH-KAI CHAN YEN-HUNG LIN PO-CHIH LIN Ho, Chen-Hsun Liu, Yu-Chun SHIH-CHIEH CHUEH VIN-CENT WU TAI-SHUAN LAI SHAO-YU YANG KAO-LANG LIU CHIN-CHEN CHANG Lee, B.-C. KUO-HOW HUANG LIAN-YU LIN SHIH-CHENG LIAO RUOH-FANG YEN CHING-CHU LU Er L.-K. Hu, Y.-H. Chang C.-H. Wu, C.-H. Tsai Y.-C. Huang W.-C. Chen Y.-Y. KWAN-DUN WU |
公開日期: | 2020 | 卷: | 11 | 來源出版物: | Therapeutic Advances in Chronic Disease | 摘要: | 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) <60 ml/min/1.73 m2 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. ? The Author(s), 2020. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/514402 | ISSN: | 2040-6223 | DOI: | 10.1177/2040622320944792 | SDG/關鍵字: | 6beta iodomethyl 19 norcholest 5(10) en 3beta ol i 131; aldosterone; alpha adrenergic receptor blocking agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; captopril; creatinine; dipeptidyl carboxypeptidase inhibitor; diuretic agent; doxazosin; potassium; vasodilator agent; adrenalectomy; adult; albumin to creatinine ratio; Article; biological activity; cohort analysis; controlled study; diabetes mellitus; diastolic blood pressure; disease registry; echocardiography; endothelial dysfunction; estimated glomerular filtration rate; evaluation and follow up; female; heart left ventricle ejection fraction; heart left ventricle mass; human; hypertension; hypokalemia; intracardiac echocardiography; investigative procedures; kidney failure; kidney function test; logistic regression analysis; major clinical study; male; microalbuminuria; middle aged; osmolality; outcome assessment; plasma renin activity; primary aldosteronism surgery outcome; primary hyperaldosteronism; prospective study; radioimmunoassay; sensitivity analysis; single photon emission computed tomography-computed tomography; systolic blood pressure; taiwan primary aldosteronism investigation registry; transtubular potassium gradient; two dimensional echocardiography; ultrafiltration; urinalysis |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。