https://scholars.lib.ntu.edu.tw/handle/123456789/514997
標題: | Adrenalectomy Improves the Long-Term Risk of End-Stage Renal Disease and Mortality of Primary Aldosteronism | 作者: | 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 |
公開日期: | 2019 | 出版社: | Oxford University Press | 卷: | 3 | 期: | 6 | 起(迄)頁: | 1110-1126 | 來源出版物: | Journal of the Endocrine Society | 摘要: | 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/關鍵字: | 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 |
顯示於: | 醫學系 |
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