Clinical characteristics and postoperative outcomes of primary aldosteronism in the elderly

Masao Takeda, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Mitsuhide Naruse, Yoshiyu Takeda, Isao Kurihara, Hiroshi Itoh, Hironobu Umakoshi, Mika Tsuiki, Takamasa Ichijo, Takuyuki Katabami, Norio Wada, Yui Shibayama, Takanobu Yoshimoto, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Katsutoshi TakahashiMegumi Fujita, Minemori Watanabe, Yuichi Matsuda, Hiroki Kobayashi, Hirotaka Shibata, Kohei Kamemura, Michio Otsuki, Yuichi Fujii, Atsushi Ogo, Shintaro Okamura, Shozo Miyauchi, Toshihiko Yanase, Tomoko Suzuki, Takashi Kawamura

研究成果: ジャーナルへの寄稿記事

5 引用 (Scopus)

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Context: Primary aldosteronism (PA) in the elderly has increased in importance in association with population aging. Objective: To investigate the characteristics and outcomes of elderly patients with PA undergoing adrenalectomy. Patients and Methods: Using a database of patients with PA who underwent adrenal venous sampling (AVS),wecompared elderly patients (65 years old)with nonelderly patients (,65 years old) in terms of characteristics, subtype classification in ACTH-stimulated AVS, and outcomes after adrenalectomy. Results: The elderly group had a higher prevalence of comorbidities than the nonelderly group. The proportion of the unilateral subtype [defined as a lateralization index (LI) .4] was comparable between the age groups. In patients who received adrenalectomy, biochemical cure was comparable between the groups, whereas persistent hypertension was more common in the elderly group. The prevalences of hyperkalemia and renal impairment (chronic kidney disease stage 3b or higher) were higher in the elderly group. Multiple regression analysis showed that the duration of hypertension predicted persistent hypertension and hyperkalemia and that preoperative estimated glomerular filtration rate predicted renal impairment in the elderly group. LI .4 in AVS was an independent predictor of biochemical cure after adrenalectomy in the elderly group but not in the nonelderly group. Age was negatively associated with biochemical cure in patients with LI #4. Conclusion: Adrenalectomy contributes to biochemical improvement in elderly patients if determined in accordance with AVS. The treatment strategy should be determined considering the high postoperative incidence of persistent hypertension and hyperkalemia in elderly patients with a long history of hypertension or renal impairment in those with reduced renal function.

元の言語英語
ページ(範囲)3620-3629
ページ数10
ジャーナルJournal of Clinical Endocrinology and Metabolism
103
発行部数10
DOI
出版物ステータス出版済み - 10 1 2018

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Takeda, M., Yamamoto, K., Akasaka, H., Rakugi, H., Naruse, M., Takeda, Y., Kurihara, I., Itoh, H., Umakoshi, H., Tsuiki, M., Ichijo, T., Katabami, T., Wada, N., Shibayama, Y., Yoshimoto, T., Ogawa, Y., Kawashima, J., Sone, M., Inagaki, N., ... Kawamura, T. (2018). Clinical characteristics and postoperative outcomes of primary aldosteronism in the elderly. Journal of Clinical Endocrinology and Metabolism, 103(10), 3620-3629. https://doi.org/10.1210/jc.2018-00059