title: Incidence and factors of post-adrenalectomy hyperkalemia in patients with aldosterone producing adenoma.
abstract: BACKGROUND
  Hyperkalemia is a potentially serious complication following adrenalectomy of aldosterone-producing adenomas (APA). We analyzed the incidence and risk factors for hyperkalemia after adrenalectomy in patients with APA.
  
  
  METHODS
  We retrospectively analyzed the records of 55 patients who underwent adrenalectomy for APA between 2002 and 2011. Demographic features, biochemical and hormonal profiles, imaging, and relevant medications were reviewed.
  
  
  RESULTS
  Sixteen of 55 APA patients (29.1%) developed hyperkalemia (mean serum K(+) 5.6±0.3 mmol/l) after adrenalectomy and 3 had persistent hyperkalemia requiring mineralocorticoid supplementation for more than nine months. Compared with normokalemic patients, hyperkalemic patients were characterized by male predominance, older age, longer duration of hypertension (12.8±9.3 vs. 6.7±5.0 y, p<0.05), lower nadir serum K(+) (p<0.05), higher preoperative serum creatinine (p<0.01), and higher likelihood of residual hypertension. Using multivariate regression analysis, longer duration of hypertension and impaired renal function were the most important factors of post-adrenalectomy hyperkalemia.
  
  
  CONCLUSIONS
  Post-adrenalectomy hyperkalemia in patients with APA is not rare and associated with impaired renal function and longer duration of hypertension. Serum K(+) must be cautiously monitored in patients with long-term hypertension and kidney disease.
authors.affiliation: Department of Medicine, Armed Forces Taoyuan General Hospital, Taoyuan, Taiwan; Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-Fang
authors.initials: WF
authors.lastname: Chiang
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Cheng
authors.forename: Sheng-Tang
authors.initials: ST
authors.lastname: Wu
authors.forename: Guang-Huan
authors.initials: GH
authors.lastname: Sun
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Lin
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Sung
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000097:blood* / Q000601:surgery; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000097:blood* / Q000601:surgery; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood* / Q000172:deficiency; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D011188:Potassium / Q000097:blood*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000450:Aldosterone; D011188:Potassium
keywords: Adrenalectomy; Hyperkalemia; Hypokalemia; Primary aldosteronism