title: Unmasked chronic renal function deterioration after unilateral adrenalectomy in patients with primary aldosteronism.
abstract: We report 2 cases of chronic estimated glomerular filtration rate (eGFR) decline after unilateral adrenalectomy due to primary aldosteronism. The patients were diagnosed with unilateral adrenal cortical adenoma releasing aldosterone. Two patients were examined for hypertension and hypokalemia. Unilateral laparoscopic adrenalectomy was performed in both cases, and pathology confirmed adrenal cortical adenoma. After adrenalectomy, hypertension and hypokalemia improved to within normal range. However, the eGFR decreased postoperatively, and abdominal computed tomography scan showed decreased kidney size compared to previous images. Kidney biopsy was performed to delineate the exact cause of renal function deterioration and revealed hypertensive changes with chronic interstitial changes, indicating that glomerular hyperfiltration with aldosterone excess masked renal function damage. Physicians have to consider the probability of postadrenalectomy eGFR decline related to chronic hypertensive change.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Su Min
authors.initials: SM
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Il Young
authors.initials: IY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.affiliation: Department of Pathology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Nari
authors.initials: N
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
keywords: Adrenalectomy; Chronic kidney disease; Glomerular filtration rate; Primary aldosteronism