The impact of superselective adrenal artery embolization on renal function in patients with primary aldosteronism: a prospective cohort study.

Autor: Lai ZQ; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Fu Y; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Liu JW; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Zhang HJ; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Zhang H; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Liang NP; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China., Dong YF; Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China. yf_dong66@126.com.; Jiangxi Key Laboratory of Molecular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China. yf_dong66@126.com.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2024 Apr; Vol. 47 (4), pp. 944-958. Date of Electronic Publication: 2023 Nov 13.
DOI: 10.1038/s41440-023-01503-8
Abstrakt: Superselective adrenal artery embolization (SAAE) is an effective treatment for patients with primary aldosteronism (PA). However, the impact of SAAE on renal function in the PA population remains uncertain. We investigated the estimated glomerular filtration rate (eGFR) and age, sex, body mass index, and diabetes-specific percentiles of eGFR residuals in 182 PA patients treated with SAAE in a prospective cohort from Nanchang SAAE in treating PA registry study. Data suggest that SAAE caused a significant decrease in eGFR from 91.9 ± 26.1 to 88.7 ± 24.1 ml/min/1.73 m 2 (p < 0.05) after a median follow-up of 8 months in PA patients. Patients experienced a significant decrease in eGFR from 110.6 ± 18.9 to 103.8 ± 18.2 ml/min/1.73 m 2 (p < 0.001) and a very slight increase from 71.1 ± 14.8 to 71.8 ± 17.8 ml/min/1.73 m 2 (p = 0.770) with baseline eGFR ≥90 and <90 ml/min/1.73 m 2 , respectively. Patients with high eGFR residuals (glomerular hyperfiltration) experienced a significant decrease in their eGFR levels from 123.1 ± 22.6 to 105.0 ± 18.6 ml/min/1.73 m 2 (p < 0.001). In contrast, there was no significant impact of SAAE on the eGFR of patients with normal or low eGFR residuals. The very early eGFR changes (24 h after SAAE) best predicted the effect of SAAE on eGFR changes after median of eight months in PA patients. On the whole, SAAE seems to have a beneficial impact on renal function in patients with PA, the results of which vary depending on the patient's baseline eGFR and glomerular hyperfiltration status.
(© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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