title: Association of kidney function with residual hypertension after treatment of aldosterone-producing adenoma.
abstract: BACKGROUND
  Autonomous secretion of aldosterone in patients with primary aldosteronism increases glomerular filtration rate and causes kidney damage. The influence of a mild decrease in kidney function on residual hypertension after adrenalectomy is unexplored.
  
  
  METHODS
  Nonconcurrent prospective study.
  
  
  METHODS
  The study was based on the Taiwan Primary Aldosteronism Investigation (TAIPAI) database. 150 patients (61 men; overall mean age, 47.2 +/- 11.6 years) with a diagnosis of aldosterone-producing adenoma had undergone unilateral adrenalectomy at National Taiwan University Hospital from July 1999 to January 2007.
  
  
  METHODS
  Presurgery estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  Residual hypertension after adrenalectomy, defined either as less than 75% of recorded blood pressure measurements with systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg or requiring antihypertensive medications during the first year after surgery.
  
  
  RESULTS
  Before surgery, 27 (18%), 72 (48%), and 51 (34%) patients had moderately to severely decreased (<60 mL/min/1.73 m(2)), mildly decreased (60 <or= eGFR < 90 mL/min/1.73 m(2)), or nondecreased eGFR (>or=90 mL/min/1.73 m(2)), respectively. After surgery, 16 (59.3%), 29 (40.3%), and 10 (19.3%) patients in each category had postsurgery residual hypertension. Compared with patients without decreased eGFR before surgery, adjusted odds ratios for postsurgery residual hypertension were 2.7 (95% confidence interval, 1.03 to 7.0; P = 0.04) and 2.8 (95% confidence interval, 1.05 to 9.3) for mildly and moderately to severely decreased eGFR, respectively.
  
  
  CONCLUSIONS
  Arbitrary definition for residual hypertension.
  
  
  CONCLUSIONS
  Two-thirds of patients with aldosterone-producing adenoma were cured of hypertension by means of unilateral adrenalectomy. Kidney function impairment, even mild, appears to be associated with a high incidence of postsurgery residual hypertension.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chueh
authors.forename: Hung-Wei
authors.initials: HW
authors.lastname: Chang
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Kao-Lang
authors.initials: KL
authors.lastname: Liu
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Yi-Luwn
authors.initials: YL
authors.lastname: Ho
authors.forename: Wei-Chou
authors.initials: WC
authors.lastname: Lin
authors.forename: Shuo-Meng
authors.initials: SM
authors.lastname: Wang
authors.forename: Kuo-How
authors.initials: KH
authors.lastname: Huang
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
authors.forename: Tze-Wah
authors.initials: TW
authors.lastname: Kao
authors.forename: Shuei-Liong
authors.initials: SL
authors.lastname: Lin
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
authors.forename: Yung-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Bor-Sen
authors.initials: BS
authors.lastname: Hsieh
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
mesh_terms: D000236:Adenoma / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000450:Aldosterone / Q000097:blood* / Q000378:metabolism; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000450:Aldosterone; D003404:Creatinine