Associations Between Changes in Plasma Renin Activity and Aldosterone Concentrations and Changes in Kidney Function After Treatment for Primary Aldosteronism.
aldosterone
blood pressure
glomerular hyperfiltration
mineralocorticoid receptor activity
primary aldosteronism
renin activity
Journal
Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
01
05
2020
revised:
01
06
2020
accepted:
09
06
2020
entrez:
11
8
2020
pubmed:
11
8
2020
medline:
11
8
2020
Statut:
epublish
Résumé
Greater reduction in estimated glomerular filtration rate (eGFR) after specific treatment for primary aldosteronism (PA) reflects improvement in glomerular hyperfiltration associated with PA and leads to better patient outcomes. However, little is known regarding the mechanisms underlying eGFR reduction after treatment for PA. We analyzed data from the nationwide PA registry in Japan. Patients were assigned to adrenalectomy (n = 438) and mineralocorticoid receptor (MR) antagonist (n = 746) groups. We assessed associations between changes in blood pressure (BP), plasma renin activity (PRA) and plasma aldosterone concentrations (PAC), and eGFR before and 6 months after treatment for both groups. In a multivariable linear regression, the adjusted β values (95% confidence interval [CI]) for change in eGFR after treatment were -2.76 (-4.29, -1.22) ml/min per 1.73 m Post-treatment improvements in glomerular hyperfiltration may be attributable to decreased MR activity in the kidneys, but not to reductions in systemic BP.
Identifiants
pubmed: 32775828
doi: 10.1016/j.ekir.2020.06.012
pii: S2468-0249(20)31335-8
pmc: PMC7403537
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1291-1297Informations de copyright
© 2020 International Society of Nephrology. Published by Elsevier Inc.
Références
Clin J Am Soc Nephrol. 2007 Jul;2(4):722-31
pubmed: 17699488
J Clin Endocrinol Metab. 2016 Jul;101(7):2826-35
pubmed: 27172433
Medicine (Baltimore). 2016 Mar;95(11):e3013
pubmed: 26986114
Hypertension. 2018 Sep;72(3):658-666
pubmed: 29987110
Am J Kidney Dis. 2018 Nov;72(5):728-744
pubmed: 29478869
BMJ Open. 2019 Sep 20;9(9):e030596
pubmed: 31542753
Am J Kidney Dis. 2010 Jul;56(1):32-8
pubmed: 20416999
Intern Med. 2018 Sep 01;57(17):2459-2466
pubmed: 29709927
J Renin Angiotensin Aldosterone Syst. 2011 Jun;12(2):113-22
pubmed: 21436207
Diabetes Care. 2019 May;42(5):938-945
pubmed: 31010944
Hypertens Res. 2013 Mar;36(3):185-90
pubmed: 23171954
J Clin Endocrinol Metab. 2009 Apr;94(4):1191-7
pubmed: 19141581
Diabetes. 2006 Jun;55(6):1832-9
pubmed: 16731850
J Am Heart Assoc. 2016 May 25;5(6):
pubmed: 27225196
Kidney Int. 2017 May;91(5):1224-1235
pubmed: 28187985
Curr Hypertens Rep. 2012 Apr;14(2):160-9
pubmed: 22302531
Hypertension. 2019 Sep;74(3):630-638
pubmed: 31327258
J Am Soc Nephrol. 2005 May;16(5):1320-5
pubmed: 15800124
Kidney Int. 2003 May;63(5):1791-800
pubmed: 12675855
Drugs. 1989 Jun;37(6):900-25
pubmed: 2667938
J Clin Hypertens (Greenwich). 2017 Mar;19(3):290-295
pubmed: 27659389
Hypertens Res. 2014 Apr;37(4):253-390
pubmed: 24705419
J Diabetes Investig. 2010 Oct 19;1(5):212-28
pubmed: 24843435
Hypertension. 2006 Aug;48(2):232-8
pubmed: 16801482
Curr Hypertens Rep. 2013 Feb;15(1):59-70
pubmed: 23242734
Lancet Diabetes Endocrinol. 2018 Jan;6(1):51-59
pubmed: 29129576
Hypertens Res. 2009 Jan;32(1):3-107
pubmed: 19300436
Endocr J. 2011;58(9):711-21
pubmed: 21828936
J Hypertens. 2019 Jul;37(7):1513-1520
pubmed: 31145370
J Endocr Soc. 2019 Mar 25;3(6):1110-1126
pubmed: 31086833
J Clin Endocrinol Metab. 2014 May;99(5):1593-8
pubmed: 24285678
Hypertension. 2007 Feb;49(2):355-64
pubmed: 17200434
JAMA. 2006 Jun 14;295(22):2638-45
pubmed: 16772627
Hypertension. 1991 Jan;17(1 Suppl):I91-6
pubmed: 1987019