title: Effect of Treatment on Body Fluid in Patients with Unilateral Aldosterone Producing Adenoma: Adrenalectomy versus Spironolactone.
abstract: Aldosterone affects fluid retention in the body by affecting how much salt and water that the kidney retains or excretes. There is limited information about the effect of prolonged aldosterone excess and treatment on body fluid in primary aldosteronism (PA) patients. In this study, body composition changes of 41 PA patients with unilateral aldosterone producing adenoma (APA) were assessed by a bio-impedance spectroscopy device. Patients with APA receiving adrenalectomy, as compared with those treated with spironolactone, had significantly lower relative overhydration (OH) and urine albumin excretion, and significantly higher urine sodium excretion four weeks after treatment. These differences dissipated 12 weeks after the initial treatment. Independent factors to predict decreased relative OH four weeks after treatment were male patients and patients who experienced adrenalectomy. Patients who underwent adrenaelctomy had significantly decreased TNF-α and increased serum potassium level when compared to patients treated with spironolactone 4 and 12 weeks after treatment. In this pilot study, we found that adrenalectomy leads to an earlier increase in renal sodium excretion and decreases in body fluid content, TNF-α, and urine albumin excretion. Adrenalectomy yields a therapeutic effect more rapidly, which has been shown to ameliorate overhydration in PA patients.
authors.affiliation: Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Che-Hsiung
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Division of General Surgery, Department of Surgery, National Taiwan University Hospital.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Szu-Chun
authors.initials: SC
authors.lastname: Hung
authors.affiliation: Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Yao-Chou
authors.initials: YC
authors.lastname: Tsai
authors.affiliation: Division of Endocrine and Metabolism, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Hu
authors.affiliation: Departments of Internal Medicine, National Taiwan University Hospital.
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Departments of Internal Medicine, National Taiwan University Hospital.
authors.forename: Tzong-Shinn
authors.initials: TS
authors.lastname: Chu
authors.affiliation: Departments of Internal Medicine, National Taiwan University Hospital.
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.affiliation: Departments of Internal Medicine, National Taiwan University Hospital.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000096:biosynthesis* / Q000097:blood; D001826:Body Fluids / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D016017:Odds Ratio; D012307:Risk Factors; D013148:Spironolactone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone