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  1. NTU Scholars
  2. 醫學院
  3. 醫學系
Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/514997
Title: Adrenalectomy Improves the Long-Term Risk of End-Stage Renal Disease and Mortality of Primary Aldosteronism
Authors: Chen Y.-Y.
You-Hsien Hugo Lin
Huang W.-C.
Chueh E.
Chen L.
SHAO-YU YANG 
Lin P.-C.
LIAN-YU LIN 
YEN-HUNG LIN 
VIN-CENT WU 
TZONG-SHINN CHU 
KWAN-DUN WU 
Issue Date: 2019
Publisher: Oxford University Press
Journal Volume: 3
Journal Issue: 6
Start page/Pages: 1110-1126
Source: Journal of the Endocrine Society
Abstract: 
Objective: Primary aldosteronism (PA) is a common cause of secondary hypertension, and the longterm effect of excess aldosterone on kidney function is unknown. Patients and Methods: We used a longitudinal population database from the Taiwan National Health Insurance system and applied a validated algorithm to identify patients with PA diagnosed between 1997 and 2009. Results: There were 2699 patients with PA recruited, of whom 761 patients with an aldosteroneproducing adenoma (APA) were identified. The incidence rate of end-stage renal disease (ESRD) was 3% in patients with PA after targeted treatments and 5.2 years of follow-up, which was comparable to the rate in controls with essential hypertension (EH). However, after taking mortality as a competing risk, we found a significantly lower incidence of ESRD when comparing patients with PA vs EH [subdistribution hazard ratio (sHR), 0.38; P50.007] and patients with APA vs EH(sHR 0.55; P50.021) after adrenalectomy; however, we did not see similar results in groups with mineralocorticoid receptor antagonist (MRA)-treated PA vs EH. There was also a significantly lower incidence of mortality in groups with PA and APA who underwent adrenalectomy than among EH controls (P , 0.001). Conclusion: Regarding incident ESRD, patients with PA were comparable to their EH counterparts after treatment. After adrenalectomy, patients with APA had better long-term outcomes regarding progression to ESRD and mortality than hypertensive controls, but MRA treatments did not significantly affect outcome. Copyright ? 2019 Endocrine Society.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072294093&doi=10.1210%2fjs.2019-00019&partnerID=40&md5=13cfa754bf52ff582d5ff39085777762
https://scholars.lib.ntu.edu.tw/handle/123456789/514997
ISSN: 2472-1972
DOI: 10.1210/js.2019-00019
SDG/Keyword: mineralocorticoid antagonist; spironolactone; adrenalectomy; adult; age; Article; Charlson Comorbidity Index; cohort analysis; comorbidity; comparative study; controlled study; end stage renal disease; essential hypertension; female; follow up; human; longitudinal study; major clinical study; male; middle aged; mortality risk; primary hyperaldosteronism; priority journal; risk assessment; treatment response
[SDGs]SDG3
Appears in Collections:醫學系

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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of “NTU Repository” with “Academic Hub” to form NTU Scholars.

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