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논문 기본 정보

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학술저널
저자정보
Jee Young Lee (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Hyoungnae Kim (Division of Nephrology Soonchunhyang University College of Medicine Seoul Korea) Hyung Woo Kim (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Geun Woo Ryu (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Yooju Nam (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Seonyeong Lee (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Young Su Joo (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Sangmi Lee (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Jung Tak Park (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Seung Hyeok Han (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Shin-Wook Kang (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Tae-Hyun Yoo (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Hae-Ryong Yun (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea)
저널정보
전해질고혈압연구회 Electrolytes & Blood Pressure Electrolytes & Blood Pressure Vol.17 No.2
발행연도
2019.1
수록면
45 - 53 (9page)

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Background: Aldosterone-induced glomerular hyperfiltration can lead to masked preoperative renal dysfunction in primary aldosteronism(PA) patients. We evaluated whether PA patients had a higher prevalence of acute kidney injury (AKI) after unilateral adrenalectomy. In addition, we identified risk factors for AKI in these subjects. Methods: This retrospective study included 107 PA patients, and 186 pheochromocytoma patients as a control group, all of whom underwent adrenalectomy between January 2006 and November 2017 at Yonsei University Severance Hospital. The primary outcome was AKI within 48 hours after adrenalectomy. Univariate and multivariate logistic regression analyses were performed to identify predictors of AKI after adrenalectomy. Results: Overall incidence of AKI was 49/293 (16.7%). In PA patients, the incidence of AKI was 29/107 (27.1%). In contrast, incidence of AKI was 20/186 (10.7%) in pheochromocytoma patients. Univariate and multivariate logistic regression analysis both showed a higher risk of postoperative AKI in PA patients compared to pheochromocytoma patients. In addition, old age, diabetes, longer duration of hypertension, lower preoperative estimated glomerular filtration rate, high aldosterone-cortisol ratio (ACR) and lateralization index (LI) were identified as independent risk factors for postoperative AKI in PA patients after unilateral adrenalectomy. Conclusion: Incidence and risk of postoperative AKI were significantly higher in PA patients after surgical treatment. High ACR on the tumor side and high LI were associated with higher risk of AKI in PA patients compared to pheochromocytoma patients.
#Primary aldosteronism #Adrenalectomy #Renal insufficiency #Pheochromocytoma

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참고문헌 (41)

참고문헌 신청
Conn JW / 1990 / Painting background. Part II. Primary aldosteronism, a new clinical syndrome, 1954 / J Lab Clin Med 116(2):253~267 google schola Funder JW / 2008 / Case detection, diagnosis, and treatment of patients with primary aldosteronism:an endocrine society clinical practice guideline / J Clin Endocrinol Metab 93(9):3266~3281 google schola Monticone S / 2019 / Renal damage in primary aldosteronism: a systematic review and meta-analysis / J Hypertens google schola Hung CS / 2019 / Aldosterone induces vascular damage / Hypertension 74(3):623~629 google schola Catena C / 2015 / Treatment of primary aldosteronism and organ protection / Int J Endocrinol 2015:597247 google schola

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