Academic Journal
Association Between Acute Fall in Estimated Glomerular Filtration Rate After Treatment for Primary Aldosteronism and Long-Term Decline in Renal Function
| العنوان: | Association Between Acute Fall in Estimated Glomerular Filtration Rate After Treatment for Primary Aldosteronism and Long-Term Decline in Renal Function |
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| المؤلفون: | Kobayashi, Hiroki, Abe, Masanori, Nakamura, Yoshihiro, Takahashi, Katsutoshi, Fujita, Megumi, Takeda, Yoshiyu, Yoneda, Takashi, Kurihara, Isao, Itoh, Hiroshi, Tsuiki, Mika, Wada, Norio, Ichijo, Takamasa, Katabami, Takuyuki, Ogawa, Yoshihiro, Kawashima, Junji, Yoshimoto, Takanobu, Sone, Masakatsu, Inagaki, Nobuya, Watanabe, Minemori, Kamemura, Kohei, Matsuda, Yuichi, Izawa, Shoichiro, Tanabe, Makito, Tanabe, Akiyo, Suzuki, Tomoko, Naruse, Mitsuhide |
| المصدر: | Hypertension ; volume 74, issue 3, page 630-638 ; ISSN 0194-911X 1524-4563 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2019 |
| الوصف: | Primary aldosteronism causes renal structural damage after glomerular hyperfiltration, and primary aldosteronism-specific treatment leads to an acute fall in estimated glomerular filtration rate (eGFR). We investigated whether this change affected the long-term eGFR slope in a retrospective cohort from the multicenter Japan Primary Aldosteronism Study. We allocated patients with primary aldosteronism to the adrenalectomy (n=202) and MR (mineralocorticoid receptor) antagonist (n=303) groups based on their treatment history and analyzed the association between the initial eGFR fall and long-term eGFR slope. The increased age, low serum potassium levels, high eGFR, and high plasma aldosterone levels were independent predictors for a large initial eGFR fall in both groups. Our analysis of tertiles based on the initial eGFR fall revealed that in the MR antagonist group, patients with a small initial eGFR fall had a significantly steeper long-term eGFR slope than those with a large initial fall (tertile 1 versus 2, P =0.025; tertile 1 versus 3, P =0.017). These associations were not identified in the adrenalectomy group. Thus, the smaller the acute fall in eGFR by initiation of MR antagonists, the greater was the rate of long-term eGFR decline. While the acute fall in eGFR induced by primary aldosteronism-specific treatment is occasionally a clinical concern, our findings highlight the favorable implications of the acute fall with respect to long-term renal outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1161/hypertensionaha.119.13131 |
| DOI: | 10.1161/HYPERTENSIONAHA.119.13131 |
| الاتاحة: | http://dx.doi.org/10.1161/hypertensionaha.119.13131 https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.119.13131 |
| رقم الانضمام: | edsbas.38B30636 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1161/hypertensionaha.119.13131 |
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