title: Relationships of plasma renin levels with renal function in patients with primary aldosteronism.
abstract: BACKGROUND
  The renal damage that is present in primary aldosteronism might reflect functional and potentially reversible abnormalities that are initiated by glomerular hyperfiltration. The aim of this study was to investigate the relationships of plasma renin and aldosterone concentrations with renal outcomes after treatment of primary aldosteronism.
  
  
  METHODS
  Fifty-six consecutive patients who had primary aldosteronism and were recruited in a university center were studied. Patients were prospectively followed after either surgical or medical treatment for a mean of 6.2 yr, during which they received antihypertensive drugs to reach a target BP of <140/90 mmHg.
  
  
  RESULTS
  At baseline, patients with primary aldosteronism had higher creatinine clearance and albuminuria than 323 patients with essential hypertension and 113 normotensive individuals. In patients with primary aldosteronism, plasma active renin levels that were higher than the lower limit of detection (2.5 pg/ml) were associated with higher BP, plasma potassium, and albuminuria and lower creatinine clearance. Plasma aldosterone concentrations that were higher than the median value (225 pg/ml) were associated with lower plasma potassium and higher creatinine clearance. Creatinine clearance was correlated directly with plasma aldosterone and inversely with renin. During follow-up, patients with higher baseline plasma renin required use of more antihypertensive drugs to obtain BP control and had a smaller early decline in albuminuria than did patients with suppressed renin.
  
  
  CONCLUSIONS
  Escape of renin from suppression by excess aldosterone is associated with evidence of more severe renal damage in patients with primary aldosteronism and predicts less favorable outcomes after treatment.
authors: Hypertension Unit, Division of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine, Udine, Italy.
authors: Cristiana
authors: C
authors: Catena
authors: GianLuca
authors: G
authors: Colussi
authors: Elisa
authors: E
authors: Nadalini
authors: Alessandra
authors: A
authors: Chiuch
authors: Sara
authors: S
authors: Baroselli
authors: Roberta
authors: R
authors: Lapenna
authors: Leonardo A
authors: LA
authors: Sechi
mesh_terms: D000450:Aldosterone / Q000097:blood*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012083:Renin / Q000097:blood*
chemical_list: D000450:Aldosterone; D012083:Renin