Long-term outcome success after operative treatment for primary aldosteronism
| Autor: | Zahra F. Khan, Mohammed Jeraq, Omar Picado, John I. Lew, Bryan W. Whitfield, Josefina C. Farrá |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Secondary hypertension 030230 surgery 03 medical and health sciences 0302 clinical medicine Primary aldosteronism Hyperaldosteronism Odds Ratio medicine Humans In patient Retrospective Studies business.industry Adrenalectomy Disease Management Odds ratio Middle Aged medicine.disease Hypokalemia Confidence interval Surgery Treatment Outcome Blood pressure 030220 oncology & carcinogenesis Female Disease Susceptibility medicine.symptom business Biomarkers |
| Zdroj: | Surgery. 169:528-532 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2020.07.046 |
| Popis: | Primary aldosteronism is a common cause of secondary hypertension. Resolution of hypertension and hypokalemia after adrenalectomy for primary aldosteronism is variable. This study examines preoperative factors for persistent hypertension and long-term outcome after laparoscopic adrenalectomy in patients with primary aldosteronism.We reviewed all patients who underwent laparoscopic resection for adrenal tumors from 2010 to 2018. Biochemical success was defined as normalization of hypokalemia and the aldosterone-to-renin ratio. Clinical success was defined as normalization of blood pressure requiring no antihypertensive medications. Descriptive statistics and binary logistic regression analysis were used.Of 202 patients who underwent unilateral laparoscopic adrenalectomy, 37 (18%) had biochemical and clinical confirmation of primary aldosteronism. Postoperatively, biochemical success was attained in all 37 patients with primary aldosteronism. Complete, partial, and absent clinical success was achieved in 41%, 38%, and 21% of patients, respectively. Number of antihypertensives (odds ratio, 2.30 per medication; 95% confidence interval, 1.07-4.93; P.05), duration of hypertension (odds ratio, 1.11 per year; 95% confidence interval, 1.03-1.25; P.05), and increased body mass index (odds ratio, 1.13; 95% confidence interval, 1.01-1.29; P.05) were preoperative factors associated with absent clinical success.Biochemical success is more common than clinical resolution of hypertension after adrenalectomy for primary aldosteronism. The number of antihypertensive medications, longstanding hypertension, and high body mass index are preoperative factors associated with absent clinical success. |
| Databáze: | OpenAIRE |
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