Impact of primary aldosteronism on renal function in patients with type 2 diabetes

Autor: Jun Saito, Tomoko Takiguchi, Yuya Tsurutani, Sho Katsuragawa, Tetsuo Nishikawa
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Blood Glucose
Male
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Urology
Renal function
030209 endocrinology & metabolism
Type 2 diabetes
030204 cardiovascular system & hematology
Diseases of the endocrine glands. Clinical endocrinology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Primary aldosteronism
Diabetes mellitus
Hyperaldosteronism
Internal Medicine
Medicine
Outpatient clinic
Humans
Renal Insufficiency
Chronic
Renal insufficiency
Aged
Retrospective Studies
Type 2 diabetes mellitus
business.industry
Type 2 Diabetes Mellitus
General Medicine
Articles
Middle Aged
medicine.disease
Prognosis
RC648-665
Clinical Science and Care
Cross-Sectional Studies
chemistry
Diabetes Mellitus
Type 2
Original Article
Female
Glycated hemoglobin
business
Glomerular hyperfiltration
Biomarkers
Follow-Up Studies
Glomerular Filtration Rate
Zdroj: Journal of Diabetes Investigation, Vol 12, Iss 2, Pp 217-225 (2021)
Journal of Diabetes Investigation
ISSN: 2040-1116
2040-1124
Popis: Aims/Introduction Renal dysfunction might quickly progress in patients with type 2 diabetes mellitus, when accompanied by hypertension. However, whether primary aldosteronism (PA), which autonomously over‐secretes aldosterone, causes additional renal damage in patients with type 2 diabetes mellitus is unclear. We evaluated the impact of PA on renal function in patients with type 2 diabetes mellitus. Materials and Methods A retrospective review of all patients with type 2 diabetes mellitus who visited Yokohama Rosai Hospital’s (Yokohama Japan) outpatient department between April 2017 and March 2018 was carried out. Records of patients with PA who underwent PA treatment by adrenalectomy or mineralocorticoid receptor antagonists (PA group) and those without PA (non‐PA group) were extracted, and renal function was compared between the two groups. Untreated PA patients were excluded, as their renal function might be overestimated as a result of glomerular hyperfiltration. Results There were 83 patients in the PA group and 1,580 patients in the non‐PA group. The PA group had significantly lower estimated glomerular filtration rates than the non‐PA group (66.3 [52.4–78.2] vs 70.5 [56.0–85.6] mL/min/1.73 m2, P = 0.047). Multiple regression analysis showed that PA was a factor for decreased estimated glomerular filtration rate, independent of age, sex, glycated hemoglobin, diuretic use and hypertension (P = 0.025). PA induced a 3.7‐mL/min/1.73 m2 (95% confidence interval 0.47–6.9) decrease in estimated glomerular filtration rate, equivalent to that induced by 4.4 years of aging. Conclusions Our results show that in patients with type 2 diabetes mellitus, PA is an independent risk factor for renal dysfunction. To prevent the progression of renal failure, PA should not be overlooked.
In this retrospective study, primary aldosteronism was an independent risk factor for renal dysfunction in patients with type 2 diabetes. To prevent the progression of renal failure, primary aldosteronism should not be overlooked, and should be promptly diagnosed and treated.
Databáze: OpenAIRE
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