Akiyuki Kawashima1, Masakatsu Sone1, Nobuya Inagaki1, Yoshiyu Takeda2, Hiroshi Itoh3, Isao Kurihara3, Hironobu Umakoshi4, Takamasa Ichijo5, Takuyuki Katabami6, Norio Wada7, Yoshihiro Ogawa8, Junji Kawashima9, Megumi Fujita10, Shozo Miyauchi11, Shintaro Okamura12, Tomikazu Fukuoka13, Toshihiko Yanase14, Shoichiro Izawa15, Yuichiro Yoshikawa16, Shigeatsu Hashimoto17, Masanobu Yamada18, Tatsuya Kai19, Tomoko Suzuki20, Mitsuhide Naruse4,21. 1. Department of Diabetes, Endocrinology and Nutrition, Kyoto University, Kyoto, Japan. 2. Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 3. Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, Japan. 4. Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 5. Department of Endocrinology and Metabolism, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan. 6. Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan. 7. Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan. 8. Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan. 9. Department of Metabolic Medicine, Faculty of Life Science, Kumamoto University, Kumamoto, Japan. 10. Division of Nephrology and Endocrinology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan. 11. Department of Diabetes and Endocrinology, Ehime Prefectural Central Hospital, Matsuyama, Japan. 12. Department of Endocrinology, Tenriyorozu Hospital, Tenri, Japan. 13. Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan. 14. Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. 15. Department of Endocrinology and Metabolism, Tottori University Hospital, Yonago, Japan. 16. Department of Endocrinology and Diabetes Mellitus, isato Kenwa Hospital, Misato, Japan. 17. Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University Hospital, Fukushima, Japan. 18. Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan. 19. Department of Cardiology, Saiseikai Tondabayahsi Hospital, Tondabayashi, Japan. 20. Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan. 21. Center of Endocrine Diseases, Takeda General Hospital, Kyoto, Japan.
Abstract
OBJECTIVE: Several clinical studies have reported that renal impairments are sometimes observed in patients with primary aldosteronism (PA). We analyzed the prevalence of renal impairments in PA patients and identified parameters that increase the risk for them. DESIGN: This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter Japan PA study (JPAS). Data were also collected from patients with essential hypertension (EHT). METHODS: We compared the prevalences of proteinuria and lowered estimated glomerular filtration rate (eGFR) between patients with PA and age, sex, blood pressure and duration of hypertension-matched patients with EHT. We also performed logistic regression analysis to identify parameters that increase the risk for these renal impairments. RESULTS: Among 2366 PA patients, the prevalences of proteinuria and lowered eGFR were 10.3 and 11.6%, respectively. The prevalence of proteinuria was significantly higher in PA patients than matched-EHT patients (16.8 vs 4.4%), whereas there was no significant difference in the prevalence of lowered eGFR (17.2 vs 15.0%). The logistic regression analysis also showed that the plasma aldosterone concentration (PAC) significantly increases the risk of proteinuria and lowered eGFR, independent of other known risk factors. CONCLUSION: Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our earlier finding that the PAC was not itself linearly associated with cardiovascular events such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may differ from that affecting the cardiovascular system.
OBJECTIVE: Several clinical studies have reported that renal impairments are sometimes observed in patients with primary aldosteronism (PA). We analyzed the prevalence of renal impairments in PA patients and identified parameters that increase the risk for them. DESIGN: This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter Japan PA study (JPAS). Data were also collected from patients with essential hypertension (EHT). METHODS: We compared the prevalences of proteinuria and lowered estimated glomerular filtration rate (eGFR) between patients with PA and age, sex, blood pressure and duration of hypertension-matched patients with EHT. We also performed logistic regression analysis to identify parameters that increase the risk for these renal impairments. RESULTS: Among 2366 PA patients, the prevalences of proteinuria and lowered eGFR were 10.3 and 11.6%, respectively. The prevalence of proteinuria was significantly higher in PA patients than matched-EHT patients (16.8 vs 4.4%), whereas there was no significant difference in the prevalence of lowered eGFR (17.2 vs 15.0%). The logistic regression analysis also showed that the plasma aldosterone concentration (PAC) significantly increases the risk of proteinuria and lowered eGFR, independent of other known risk factors. CONCLUSION: Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our earlier finding that the PAC was not itself linearly associated with cardiovascular events such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may differ from that affecting the cardiovascular system.
Authors: Corinna Göppner; Ian J Orozco; Maja B Hoegg-Beiler; Audrey H Soria; Christian A Hübner; Fabio L Fernandes-Rosa; Sheerazed Boulkroun; Maria-Christina Zennaro; Thomas J Jentsch Journal: Nat Commun Date: 2019-10-15 Impact factor: 14.919
Authors: Xiao Lin; Muhammad Hasnain Ehsan Ullah; Xiong Wu; Feng Xu; Su-Kang Shan; Li-Min Lei; Ling-Qing Yuan; Jun Liu Journal: Front Cardiovasc Med Date: 2022-02-02