Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment
BACKGROUNDCross-sectional studies have reported an elevated prevalence of renal cysts in patients with primary aldosteronism. The nature of this association could be related to hypokalemia and/or hypertension and has never been evaluated in prospective studies. METHODSA consecutive sample of 54 pati...
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| Veröffentlicht in: | Journal of hypertension 2007-07, Vol.25 (7), p.1443-1450 |
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| creator | Novello, Marileda Catena, Cristiana Nadalini, Elisa Colussi, Gian Luca Baroselli, Sara Chiuch, Alessandra Lapenna, Roberta Bazzocchi, Massimo Sechi, Leonardo A |
| description | BACKGROUNDCross-sectional studies have reported an elevated prevalence of renal cysts in patients with primary aldosteronism. The nature of this association could be related to hypokalemia and/or hypertension and has never been evaluated in prospective studies.
METHODSA consecutive sample of 54 patients with tumoral or idiopathic primary aldosteronism was followed after adrenalectomy or treatment with aldosterone antagonists. At baseline, renal cysts were evaluated by renal ultrasound and patients with primary aldosteronism were compared with 323 essential hypertension patients with the same severity and duration of disease, and 113 age- and sex-matched normotensive subjects.
RESULTSThe adjusted prevalence and average number of renal cysts were significantly greater in patients with primary aldosteronism than in patients with essential hypertension and normotensive subjects. Multivariate analysis revealed that age and plasma potassium levels were independently associated with the presence of renal cysts in patients with primary aldosteronism. Treatment of primary aldosteronism decreased blood pressure (BP) and restored normal potassium concentrations. After a median follow-up of 6.2 years, no significant change from baseline of cyst number and cyst total volume was observed in patients with both tumoral and idiopathic aldosteronism and in a subset of 100 patients with essential hypertension. In patients with primary aldosteronism, stepwise logistic analysis showed that the presence of renal cysts was associated with worse BP outcome after treatment.
CONCLUSIONRenal cystic disease is highly frequent in patients with primary aldosteronism and either surgical or medical treatment halt its progression, supporting the contention that hypokalemia and its severity are the main contributors to cyst formation in these patients. |
| doi_str_mv | 10.1097/HJH.0b013e328126855b |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70604318</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70604318</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3801-a5be3579000226e11298a48067bafaacaa3a65cf92c8083d487f38cf99ffaaeb3</originalsourceid><addsrcrecordid>eNpdkEGLFDEQhYMo7rj6D0Ry0VvWStLppL3Joo6yIIieQ3U6cdpNd8akm2H-vVm2YUByCKl6ryrvI-Q1hxsOnX6__7a_gR649FIYLlqjVP-E7HijJVOqM0_JDkQrWSuVuCIvSvkDAKbT8jm54lrVcqt3ZPjhZ4zUnctSKM4DPZyP6R6jn0ak40yPeZwwnynGIZXF5zSPZfpAsy9rrI4UaEzzb1Y7Ew0pxnRi65FiqAW6ZI_L5OflJXkWMBb_aruvya_Pn37e7tnd9y9fbz_eMScNcIaq91Lprv5TiNZzLjqDjYFW9xgQHaLEVrnQCWfAyKExOkhT312obd_La_Luce4xp7-rL4udxuJ8jDj7tBaroYVGclOFzaPQ5VRK9sFuOS0H-0DXVrr2f7rV9mabv_aTHy6mDWcVvN0EWBzGkHF2Y7nojOHagLrsP6VYSZX7uJ58tgePcTnYmh9qNsEEgK4HgD0g4fIfYqGUtw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70604318</pqid></control><display><type>article</type><title>Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment</title><source>MEDLINE</source><source>Journals@Ovid Ovid Autoload</source><creator>Novello, Marileda ; Catena, Cristiana ; Nadalini, Elisa ; Colussi, Gian Luca ; Baroselli, Sara ; Chiuch, Alessandra ; Lapenna, Roberta ; Bazzocchi, Massimo ; Sechi, Leonardo A</creator><creatorcontrib>Novello, Marileda ; Catena, Cristiana ; Nadalini, Elisa ; Colussi, Gian Luca ; Baroselli, Sara ; Chiuch, Alessandra ; Lapenna, Roberta ; Bazzocchi, Massimo ; Sechi, Leonardo A</creatorcontrib><description>BACKGROUNDCross-sectional studies have reported an elevated prevalence of renal cysts in patients with primary aldosteronism. The nature of this association could be related to hypokalemia and/or hypertension and has never been evaluated in prospective studies.
METHODSA consecutive sample of 54 patients with tumoral or idiopathic primary aldosteronism was followed after adrenalectomy or treatment with aldosterone antagonists. At baseline, renal cysts were evaluated by renal ultrasound and patients with primary aldosteronism were compared with 323 essential hypertension patients with the same severity and duration of disease, and 113 age- and sex-matched normotensive subjects.
RESULTSThe adjusted prevalence and average number of renal cysts were significantly greater in patients with primary aldosteronism than in patients with essential hypertension and normotensive subjects. Multivariate analysis revealed that age and plasma potassium levels were independently associated with the presence of renal cysts in patients with primary aldosteronism. Treatment of primary aldosteronism decreased blood pressure (BP) and restored normal potassium concentrations. After a median follow-up of 6.2 years, no significant change from baseline of cyst number and cyst total volume was observed in patients with both tumoral and idiopathic aldosteronism and in a subset of 100 patients with essential hypertension. In patients with primary aldosteronism, stepwise logistic analysis showed that the presence of renal cysts was associated with worse BP outcome after treatment.
CONCLUSIONRenal cystic disease is highly frequent in patients with primary aldosteronism and either surgical or medical treatment halt its progression, supporting the contention that hypokalemia and its severity are the main contributors to cyst formation in these patients.</description><identifier>ISSN: 0263-6352</identifier><identifier>EISSN: 1473-5598</identifier><identifier>DOI: 10.1097/HJH.0b013e328126855b</identifier><identifier>PMID: 17563567</identifier><identifier>CODEN: JOHYD3</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adrenalectomy ; Aldosterone - metabolism ; Antihypertensive agents ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular system ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Humans ; Hyperaldosteronism - complications ; Hyperaldosteronism - metabolism ; Hyperaldosteronism - therapy ; Hypertension - complications ; Hypertension - metabolism ; Hypertension - therapy ; Hypokalemia - epidemiology ; Hypokalemia - etiology ; Hypokalemia - metabolism ; Italy - epidemiology ; Kidney Diseases, Cystic - epidemiology ; Kidney Diseases, Cystic - etiology ; Kidney Diseases, Cystic - metabolism ; Medical sciences ; Mineralocorticoid Receptor Antagonists - therapeutic use ; Pharmacology. Drug treatments ; Prevalence ; Prospective Studies ; Spironolactone - therapeutic use ; Vertebrates: urinary system</subject><ispartof>Journal of hypertension, 2007-07, Vol.25 (7), p.1443-1450</ispartof><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3801-a5be3579000226e11298a48067bafaacaa3a65cf92c8083d487f38cf99ffaaeb3</citedby><cites>FETCH-LOGICAL-c3801-a5be3579000226e11298a48067bafaacaa3a65cf92c8083d487f38cf99ffaaeb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18817805$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17563567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Novello, Marileda</creatorcontrib><creatorcontrib>Catena, Cristiana</creatorcontrib><creatorcontrib>Nadalini, Elisa</creatorcontrib><creatorcontrib>Colussi, Gian Luca</creatorcontrib><creatorcontrib>Baroselli, Sara</creatorcontrib><creatorcontrib>Chiuch, Alessandra</creatorcontrib><creatorcontrib>Lapenna, Roberta</creatorcontrib><creatorcontrib>Bazzocchi, Massimo</creatorcontrib><creatorcontrib>Sechi, Leonardo A</creatorcontrib><title>Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment</title><title>Journal of hypertension</title><addtitle>J Hypertens</addtitle><description>BACKGROUNDCross-sectional studies have reported an elevated prevalence of renal cysts in patients with primary aldosteronism. The nature of this association could be related to hypokalemia and/or hypertension and has never been evaluated in prospective studies.
METHODSA consecutive sample of 54 patients with tumoral or idiopathic primary aldosteronism was followed after adrenalectomy or treatment with aldosterone antagonists. At baseline, renal cysts were evaluated by renal ultrasound and patients with primary aldosteronism were compared with 323 essential hypertension patients with the same severity and duration of disease, and 113 age- and sex-matched normotensive subjects.
RESULTSThe adjusted prevalence and average number of renal cysts were significantly greater in patients with primary aldosteronism than in patients with essential hypertension and normotensive subjects. Multivariate analysis revealed that age and plasma potassium levels were independently associated with the presence of renal cysts in patients with primary aldosteronism. Treatment of primary aldosteronism decreased blood pressure (BP) and restored normal potassium concentrations. After a median follow-up of 6.2 years, no significant change from baseline of cyst number and cyst total volume was observed in patients with both tumoral and idiopathic aldosteronism and in a subset of 100 patients with essential hypertension. In patients with primary aldosteronism, stepwise logistic analysis showed that the presence of renal cysts was associated with worse BP outcome after treatment.
CONCLUSIONRenal cystic disease is highly frequent in patients with primary aldosteronism and either surgical or medical treatment halt its progression, supporting the contention that hypokalemia and its severity are the main contributors to cyst formation in these patients.</description><subject>Adrenalectomy</subject><subject>Aldosterone - metabolism</subject><subject>Antihypertensive agents</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Hyperaldosteronism - complications</subject><subject>Hyperaldosteronism - metabolism</subject><subject>Hyperaldosteronism - therapy</subject><subject>Hypertension - complications</subject><subject>Hypertension - metabolism</subject><subject>Hypertension - therapy</subject><subject>Hypokalemia - epidemiology</subject><subject>Hypokalemia - etiology</subject><subject>Hypokalemia - metabolism</subject><subject>Italy - epidemiology</subject><subject>Kidney Diseases, Cystic - epidemiology</subject><subject>Kidney Diseases, Cystic - etiology</subject><subject>Kidney Diseases, Cystic - metabolism</subject><subject>Medical sciences</subject><subject>Mineralocorticoid Receptor Antagonists - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Spironolactone - therapeutic use</subject><subject>Vertebrates: urinary system</subject><issn>0263-6352</issn><issn>1473-5598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEGLFDEQhYMo7rj6D0Ry0VvWStLppL3Joo6yIIieQ3U6cdpNd8akm2H-vVm2YUByCKl6ryrvI-Q1hxsOnX6__7a_gR649FIYLlqjVP-E7HijJVOqM0_JDkQrWSuVuCIvSvkDAKbT8jm54lrVcqt3ZPjhZ4zUnctSKM4DPZyP6R6jn0ak40yPeZwwnynGIZXF5zSPZfpAsy9rrI4UaEzzb1Y7Ew0pxnRi65FiqAW6ZI_L5OflJXkWMBb_aruvya_Pn37e7tnd9y9fbz_eMScNcIaq91Lprv5TiNZzLjqDjYFW9xgQHaLEVrnQCWfAyKExOkhT312obd_La_Luce4xp7-rL4udxuJ8jDj7tBaroYVGclOFzaPQ5VRK9sFuOS0H-0DXVrr2f7rV9mabv_aTHy6mDWcVvN0EWBzGkHF2Y7nojOHagLrsP6VYSZX7uJ58tgePcTnYmh9qNsEEgK4HgD0g4fIfYqGUtw</recordid><startdate>200707</startdate><enddate>200707</enddate><creator>Novello, Marileda</creator><creator>Catena, Cristiana</creator><creator>Nadalini, Elisa</creator><creator>Colussi, Gian Luca</creator><creator>Baroselli, Sara</creator><creator>Chiuch, Alessandra</creator><creator>Lapenna, Roberta</creator><creator>Bazzocchi, Massimo</creator><creator>Sechi, Leonardo A</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200707</creationdate><title>Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment</title><author>Novello, Marileda ; Catena, Cristiana ; Nadalini, Elisa ; Colussi, Gian Luca ; Baroselli, Sara ; Chiuch, Alessandra ; Lapenna, Roberta ; Bazzocchi, Massimo ; Sechi, Leonardo A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3801-a5be3579000226e11298a48067bafaacaa3a65cf92c8083d487f38cf99ffaaeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adrenalectomy</topic><topic>Aldosterone - metabolism</topic><topic>Antihypertensive agents</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Hyperaldosteronism - complications</topic><topic>Hyperaldosteronism - metabolism</topic><topic>Hyperaldosteronism - therapy</topic><topic>Hypertension - complications</topic><topic>Hypertension - metabolism</topic><topic>Hypertension - therapy</topic><topic>Hypokalemia - epidemiology</topic><topic>Hypokalemia - etiology</topic><topic>Hypokalemia - metabolism</topic><topic>Italy - epidemiology</topic><topic>Kidney Diseases, Cystic - epidemiology</topic><topic>Kidney Diseases, Cystic - etiology</topic><topic>Kidney Diseases, Cystic - metabolism</topic><topic>Medical sciences</topic><topic>Mineralocorticoid Receptor Antagonists - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Spironolactone - therapeutic use</topic><topic>Vertebrates: urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Novello, Marileda</creatorcontrib><creatorcontrib>Catena, Cristiana</creatorcontrib><creatorcontrib>Nadalini, Elisa</creatorcontrib><creatorcontrib>Colussi, Gian Luca</creatorcontrib><creatorcontrib>Baroselli, Sara</creatorcontrib><creatorcontrib>Chiuch, Alessandra</creatorcontrib><creatorcontrib>Lapenna, Roberta</creatorcontrib><creatorcontrib>Bazzocchi, Massimo</creatorcontrib><creatorcontrib>Sechi, Leonardo A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Novello, Marileda</au><au>Catena, Cristiana</au><au>Nadalini, Elisa</au><au>Colussi, Gian Luca</au><au>Baroselli, Sara</au><au>Chiuch, Alessandra</au><au>Lapenna, Roberta</au><au>Bazzocchi, Massimo</au><au>Sechi, Leonardo A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment</atitle><jtitle>Journal of hypertension</jtitle><addtitle>J Hypertens</addtitle><date>2007-07</date><risdate>2007</risdate><volume>25</volume><issue>7</issue><spage>1443</spage><epage>1450</epage><pages>1443-1450</pages><issn>0263-6352</issn><eissn>1473-5598</eissn><coden>JOHYD3</coden><abstract>BACKGROUNDCross-sectional studies have reported an elevated prevalence of renal cysts in patients with primary aldosteronism. The nature of this association could be related to hypokalemia and/or hypertension and has never been evaluated in prospective studies.
METHODSA consecutive sample of 54 patients with tumoral or idiopathic primary aldosteronism was followed after adrenalectomy or treatment with aldosterone antagonists. At baseline, renal cysts were evaluated by renal ultrasound and patients with primary aldosteronism were compared with 323 essential hypertension patients with the same severity and duration of disease, and 113 age- and sex-matched normotensive subjects.
RESULTSThe adjusted prevalence and average number of renal cysts were significantly greater in patients with primary aldosteronism than in patients with essential hypertension and normotensive subjects. Multivariate analysis revealed that age and plasma potassium levels were independently associated with the presence of renal cysts in patients with primary aldosteronism. Treatment of primary aldosteronism decreased blood pressure (BP) and restored normal potassium concentrations. After a median follow-up of 6.2 years, no significant change from baseline of cyst number and cyst total volume was observed in patients with both tumoral and idiopathic aldosteronism and in a subset of 100 patients with essential hypertension. In patients with primary aldosteronism, stepwise logistic analysis showed that the presence of renal cysts was associated with worse BP outcome after treatment.
CONCLUSIONRenal cystic disease is highly frequent in patients with primary aldosteronism and either surgical or medical treatment halt its progression, supporting the contention that hypokalemia and its severity are the main contributors to cyst formation in these patients.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17563567</pmid><doi>10.1097/HJH.0b013e328126855b</doi><tpages>8</tpages></addata></record> |
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| subjects | Adrenalectomy Aldosterone - metabolism Antihypertensive agents Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular system Follow-Up Studies Fundamental and applied biological sciences. Psychology Humans Hyperaldosteronism - complications Hyperaldosteronism - metabolism Hyperaldosteronism - therapy Hypertension - complications Hypertension - metabolism Hypertension - therapy Hypokalemia - epidemiology Hypokalemia - etiology Hypokalemia - metabolism Italy - epidemiology Kidney Diseases, Cystic - epidemiology Kidney Diseases, Cystic - etiology Kidney Diseases, Cystic - metabolism Medical sciences Mineralocorticoid Receptor Antagonists - therapeutic use Pharmacology. Drug treatments Prevalence Prospective Studies Spironolactone - therapeutic use Vertebrates: urinary system |
| title | Renal cysts and hypokalemia in primary aldosteronism: results of long-term follow-up after treatment |
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