keyword
https://read.qxmd.com/read/38318706/unilateral-primary-aldosteronism-long-term-disease-recurrence-after-adrenalectomy
#21
JOURNAL ARTICLE
Martina Tetti, Denise Brüdgam, Jacopo Burrello, Aaron M Udager, Anna Riester, Thomas Knösel, Felix Beuschlein, William E Rainey, Martin Reincke, Tracy Ann Williams
BACKGROUND: Primary aldosteronism (PA) is frequently caused by a unilateral aldosterone-producing adenoma with a PA-driver mutation. Unilateral adrenalectomy has a high probability of short-term biochemical remission, but long-term postsurgical outcomes are relatively undefined. Our objective was to investigate the incidence of long-term recurrence of PA in individuals with postsurgical short-term biochemical remission. METHODS: Adrenalectomized patients for unilateral PA were included from a single referral center...
February 6, 2024: Hypertension
https://read.qxmd.com/read/38318433/comparison-of-plasma-aldosterone-measured-by-chemiluminescence-immunoassay-and-liquid-chromatography-tandem-mass-spectrometry-in-screening-test-for-primary-aldosteronism
#22
JOURNAL ARTICLE
Wenzhan Chen, Fenghua Lai, Xiaoyu Huang, Shuang Yu, Nan Chen, Changliu Xu, Chenxue Wang, Shuhui Liang, Yanbing Li, Haipeng Xiao, Xiaopei Cao
BACKGROUND: Whether chemiluminescence immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) for plasma aldosterone concentration (PAC) measurement can be used interchangeably in primary aldosteronism (PA) screening is still controversial. The purpose of this study was to compare CLIA to LC-MS/MS for PAC measurement in PA screening. METHODS: All participants underwent aldosterone-to-renin ratio (ARR) testing. PA was diagnosed by captopril challenge test or saline infusion test...
March 2024: Practical Laboratory Medicine
https://read.qxmd.com/read/38314382/hydroxychloroquine-induces-remission-for-iga-nephropathy-with-mild-to-moderate-proteinuria-a-single-centered-retrospective-analysis
#23
JOURNAL ARTICLE
Yixuan Pan, Jingyun Le, Lan Lan, Yaomin Wang, Guangjun Liu, Xiaoqi Shen, Pingping Ren, Jianghua Chen, Fei Han
BACKGROUND: Hydroxychloroquine (HCQ) influences both toll-like receptor (TLR) signaling and leukocyte activation, which are speculated to play a role in the pathogenesis of IgA nephropathy (IgAN). METHODS: This is a single-centered retrospective study involving 426 IgAN patients diagnosed from May 2016 to August 2020. All patients were matched according to a propensity score matching (PSM) to produce three groups: renin-angiotensin-aldosterone system inhibitors (RAASi) group (RAASi only), corticosteroids group (corticosteroids only or combined with RAASi), and HCQ group (HCQ only or combined with RAASi), consisting of 63 patients for each group...
February 2024: Curēus
https://read.qxmd.com/read/38313163/utilizing-dehydroepiandrosterone-sulfate-and-its-ratio-for-detecting-mild-autonomous-cortisol-excess-in-patients-with-adrenal-incidentaloma
#24
JOURNAL ARTICLE
Dheyaa Al-Waeli, Haider Alidrisi, Abbas Mansour
Subclinical Cushing syndrome is a condition of mild autonomous cortisol excess (MACE) that lacks typical features of Cushing syndrome but is associated with many complications. It represents a common hormonal dysfunction among patients with adrenal incidentaloma (AI), defined as unexpected masses or lesions found in the adrenal glands during radiological examinations of the chest or abdomen unrelated to adrenal gland assessment. The study evaluated the accuracy of dehydroepiandrosterone sulfate (DHEA-S) and dehydroepiandrosterone sulfate ratio (calculated by dividing the DHEA-S value by the age and sex-adjusted normal range of DHEA-S) in detecting MACE in AI patients...
October 2023: Journal of Medicine and Life
https://read.qxmd.com/read/38292832/the-prevalence-and-risk-factors-of-hyperkalemia-in-the-outpatient-setting
#25
JOURNAL ARTICLE
Chadapa Sevamontree, Supreeya Jintajirapan, Pran Phakdeekitcharoen, Bunyong Phakdeekitcharoen
BACKGROUND: Hyperkalemia is a life-threatening condition in outpatient and emergency departments. Hyperkalemia is associated with more events of major adverse cardiovascular diseases, hospitalization, and death. The aim of this study is to study and assess the prevalence and risk factors for developing hyperkalemia within the Thai population. METHOD: A cross-sectional observational study of 3,299 unique adult patients (≥18 years) in one calendar year (2021) with at least 1 valid serum potassium (SK) test was conducted in the outpatient department of medicine...
2024: International Journal of Nephrology
https://read.qxmd.com/read/38288523/the-clinical-impact-of-sample-storage-at-20%C3%A2-c-on-renin-reference-intervals-and-aldosterone-renin-ratio-calculations
#26
JOURNAL ARTICLE
Ömer Özcan, Jacquelien J Hillebrand, Wendy den Elzen, Annemieke C Heijboer
Cryoactivation was known to occur in whole blood and plasma samples when kept between +4 and -5°C leading to falsely high renin concentrations. In 2022 it has been clearly shown that cryoactivation can also occur in samples stored at -20°C.Based on these new findings here we discuss how this can influence the clinical diagnosis of patients. First, we show that storage of renin plasma samples can affect the renin measurements and thereby the aldosterone-to-renin ratio (ARR) calculation, which might explain the high intra-individual variability in ARR also recently demonstrated...
January 30, 2024: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/38270079/optimizing-the-aldosterone-to-renin-ratio-cut-off-for-screening-primary-aldosteronism-based-on-cardiovascular-risk-a-collaborative-study
#27
JOURNAL ARTICLE
Chunxue He, Ruolin Li, Jun Yang, Hang Shen, Yue Wang, Xiangjun Chen, Wenjin Luo, Qinglian Zeng, Linqiang Ma, Ying Song, Qingfeng Cheng, Zhihong Wang, Fei-Fei Wu, Qifu Li, Shumin Yang, Jinbo Hu
OBJECTIVES: Aldosterone-to-renin ratio (ARR) based screening is the first step in the diagnosis of primary aldosteronism (PA). However, the guideline-recommended ARR cutoff covers a wide range, from the equivalent of 1.3 to 4.9 ng·dl-1 /mIU∙l-1 . We aimed to optimize the ARR cutoff for PA screening based on the risk of cardiovascular diseases (CVD). METHODS: Longitudinally, we included hypertensive participants from the Framingham Offspring Study (FOS) who attended the sixth examination cycle and followed up until 2014...
December 31, 2024: Clinical and Experimental Hypertension: CHE
https://read.qxmd.com/read/38261997/healthcare-challenges-in-the-management-of-primary-aldosteronism-in-southeast-asia
#28
JOURNAL ARTICLE
Norlela Sukor, Sarat Sunthornyothin, Tran Viet Thang, Tri Juli Tarigan, Leilani B Mercado-Asis, Satha Sum, Moe Wint Aung, Alice M L Yong, Tania Tedjo, Michael Villa, Nang Ei Ei Khaing, Elena Aisha Azizan, Waye Hann Kang, Vivien Lim, Ada E D Teo, Meifen Zhang, Hieu Tran, Troy H Puar
OBJECTIVE: While guidelines have been formulated for the management of primary aldosteronism (PA), following these recommendations may be challenging in developing countries with limited healthcare access. Hence, we aimed to assess the availability and affordability of healthcare resources for managing PA in the Association of Southeast Asian Nations (ASEAN) region, which includes low-middle-income countries. DESIGN: We instituted a questionnaire-based survey to specialists managing PA, assessing the availability and affordability of investigations and treatment...
January 23, 2024: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/38256430/autoimmune-implications-in-a-patient-with-graves-hyperthyroidism-pre-eclampsia-with-severe-features-and-primary-aldosteronism
#29
Benjamin Lin, Lauren Robinson, Basem Soliman, Jill Gulizia, Stephen Usala
Background and Objectives : Graves' disease (GD) and primary aldosteronism (PA) are two pathologies that can cause significant morbidity and mortality. GD is mediated by autoantibodies, and recent studies have shown autoantibody involvement in the pathophysiology behind both PA and pre-eclampsia. The coexistence of GD and PA, however, is reportedly rare. This report describes a unique case of Graves' hyperthyroidism and concomitant PA in a patient with a history of pre-eclampsia with severe features. Case Presentation : The patient presented at 17 weeks pregnancy with mild hyperthyroidism, negative TSH receptor antibodies, and a low level of thyroid-stimulating immunoglobulins (TSI)...
January 17, 2024: Medicina
https://read.qxmd.com/read/38255973/what-we-know-about-and-what-is-new-in-primary-aldosteronism
#30
REVIEW
Natalia Ekman, Ashley B Grossman, Dorota Dworakowska
Primary aldosteronism (PA), a significant and curable cause of secondary hypertension, is seen in 5-10% of hypertensive patients, with its prevalence contingent upon the severity of the hypertension. The principal aetiologies of PA include bilateral idiopathic hypertrophy (BIH) and aldosterone-producing adenomas (APAs), while the less frequent causes include unilateral hyperplasia, familial hyperaldosteronism (FH) types I-IV, aldosterone-producing carcinoma, and ectopic aldosterone synthesis. This condition, characterised by excessive aldosterone secretion, leads to augmented sodium and water reabsorption alongside potassium loss, culminating in distinct clinical hallmarks: elevated aldosterone levels, suppressed renin levels, and hypertension...
January 11, 2024: International Journal of Molecular Sciences
https://read.qxmd.com/read/38180077/captopril-challenge-test-an-underutilized-test-in-the-diagnosis-of-primary-aldosteronism
#31
REVIEW
Sharmin Jahan, Jun Yang, Jinbo Hu, Qifu Li, Peter J Fuller
Primary aldosteronism (PA) is the most common cause of endocrine hypertension and is often underdiagnosed. This condition is associated with increased cardiovascular morbidity and mortality in comparison to age and blood pressure matched individuals with essential hypertension (EH). The diagnostic pathway for PA consists of three phases: screening, confirmatory testing, and subtyping. The lack of specificity in the screening step, which relies on the aldosterone to renin ratio, necessitates confirmatory testing...
January 1, 2024: Endocrine Connections
https://read.qxmd.com/read/38174562/multifocal-asymmetric-bilateral-primary-aldosteronism-cannot-be-excluded-by-strong-adrenal-vein-sampling-lateralization-an-international-retrospective-cohort-study
#32
JOURNAL ARTICLE
Adina F Turcu, Yuta Tezuka, Jung Soo Lim, Zara Salman, Kartik Sehgal, Haiping Liu, Stéphanie Larose, Wasita Warachit Parksook, Tracy Ann Williams, Debbie L Cohen, Heather Wachtel, Jinghong Zhang, Pranav Dorwal, Fumitoshi Satoh, Jun Yang, André Lacroix, Martin Reincke, Tom J Giordano, Aaron M Udager, Anand Vaidya, William E Rainey
BACKGROUND: Primary aldosteronism (PA) has been broadly dichotomized into unilateral and bilateral forms. Adrenal vein sampling (AVS) lateralization indices (LI) ≥2 to 4 are the standard-of-care to recommend unilateral adrenalectomy for presumed unilateral PA. We aimed to assess the rates and characteristics of residual PA after AVS-guided adrenalectomy. METHODS: We conducted an international, retrospective, cohort study of patients with PA from 7 referral centers who underwent unilateral adrenalectomy based on LI≥4 on baseline and/or cosyntropin-stimulated AVS...
March 2024: Hypertension
https://read.qxmd.com/read/38156095/adrenal-vein-sampling-in-the-management-of-primary-aldosteronism-the-added-value-of-intraprocedural-cortisol-assessment
#33
JOURNAL ARTICLE
Inês Manique, Sara Amaral, Alexandra Matias, Bruno Bouça, Salomé Serranito, João Torres, Olga Gutu, Tiago Bilhim, Élia Coimbra, Isaura Rodrigues, Conceição Godinho, Luísa Cortez, José Silva-Nunes
INTRODUCTION: Primary aldosteronism is the most common cause of secondary hypertension. Adrenal vein sampling is the gold standard for subtyping primary aldosteronism. However, this procedure is technically challenging and often has a low success rate. Our center is one of the very few performing this technique in our country with an increasing experience. OBJECTIVE: The aim of this study was to evaluate the role of the cortisol intraprocedural assay in improving the performance of adrenal vein sampling...
2023: International Journal of Endocrinology
https://read.qxmd.com/read/38155663/fluid-homeostatic-action-of-dapagliflozin-in-patients-with-chronic-kidney-disease-the-dapa-body-trial
#34
JOURNAL ARTICLE
Kentaro Oka, Takahiro Masuda, Ken Ohara, Marina Miura, Masato Morinari, Kyohei Misawa, Yasuharu Miyazawa, Tetsu Akimoto, Kazuyuki Shimada, Daisuke Nagata
Sodium glucose cotransporter 2 (SGLT2) inhibitors have both glucose-lowering and diuretic effects. We recently reported that the SGLT2 inhibitor dapagliflozin exerts short-term fluid homeostatic action in patients with chronic kidney disease (CKD). However, the long-term effects of SGLT2 inhibitors on body fluid status in patients with CKD remain unclear. This was a prospective, non-randomized, open-label study that included a dapagliflozin treatment group ( n = 73) and a control group ( n  = 24) who were followed for 6 months...
2023: Frontiers in Medicine
https://read.qxmd.com/read/38137695/blood-haemoglobin-concentration-is-directly-and-independently-related-with-pulse-wave-velocity-a-measure-of-large-artery-stiffness
#35
JOURNAL ARTICLE
Manoj Kumar Choudhary, Heidi Bouquin, Jere Hytönen, Jenni K Koskela, Onni Niemelä, Pasi I Nevalainen, Jukka Mustonen, Ilkka Pörsti
High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass index was higher in the highest versus the lowest haemoglobin tertile...
December 11, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/38116359/a-brief-review-of-diagnostic-techniques-and-clinical-management-in-chronic-kidney-disease
#36
REVIEW
Anant Shourya Chouhan, Meghali Kaple, Snehlata Hingway
Given its increasing incidence and detrimental effects on life expectancy and quality of life, chronic kidney disease (CKD) is a significant worldwide health concern. This review article provides a complete summary of current information on the diagnosis and management of CKD, focusing on recent advances and innovative approaches. The article discusses the most current findings on CKD risk assessment, emphasizing the need for early diagnosis utilizing better biomarkers and predictive models. A rigorous examination of diagnostic tools such as albumin-to-creatinine ratio (ACR) in urine and glomerular filtration rate (GFR) highlights their importance in determining CKD phases and etiologies...
November 2023: Curēus
https://read.qxmd.com/read/38116128/association-between-renal-sinus-fat-and-cardiometabolic-and-renin-angiotensin-system-parameters-in-primary-aldosteronism
#37
JOURNAL ARTICLE
Ryunosuke Mitsuno, Kenji Kaneko, Toshifumi Nakamura, Daiki Kojima, Yosuke Mizutani, Tatsuhiko Azegami, Shintaro Yamaguchi, Yoshitake Yamada, Masahiro Jinzaki, Kenichiro Kinouchi, Jun Yoshino, Kaori Hayashi
CONTEXT: Renal sinus fat (RSF) accumulation is associated with cardiometabolic diseases, such as obesity, diabetes, hypertension, and chronic kidney disease. However, clinical implications of RSF in primary aldosteronism (PA) remain unclear. OBJECTIVE: We aimed to investigate relationships between RSF volume and key cardiometabolic and renin-angiotensin system (RAS) parameters in PA patients and clarify the differences in these relationships between unilateral and bilateral subtypes...
December 1, 2023: Journal of the Endocrine Society
https://read.qxmd.com/read/38109916/efficacy-and-safety-of-aldosterone-synthase-inhibition-with-and-without-empagliflozin-for-chronic-kidney-disease-a-randomised-controlled-phase-2-trial
#38
RANDOMIZED CONTROLLED TRIAL
Katherine R Tuttle, Sibylle J Hauske, Maria Eugenia Canziani, Maria Luiza Caramori, David Cherney, Lisa Cronin, Hiddo J L Heerspink, Christian Hugo, Masaomi Nangaku, Ricardo Correa Rotter, Arnold Silva, Shimoli V Shah, Zhichao Sun, Dorothea Urbach, Dick de Zeeuw, Peter Rossing
BACKGROUND: Excess aldosterone accelerates chronic kidney disease progression. This phase 2 clinical trial assessed BI 690517, an aldosterone synthase inhibitor, for efficacy, safety, and dose selection. METHODS: This was a multinational, randomised, controlled, phase 2 trial. People aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 30 to less than 90 mL/min/1·73 m2 , a urine albumin to creatinine ratio (UACR) of 200 to less than 5000 mg/g, and serum potassium of 4·8 mmol/L or less, taking an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, were enrolled...
January 27, 2024: Lancet
https://read.qxmd.com/read/38095087/diagnostic-delay-and-disease-burden-in-primary-aldosteronism-an-international-patient-survey
#39
JOURNAL ARTICLE
Roshan A Ananda, Stella May Gwini, Katrina M Long, Jordan H Lai, Gang Chen, Grant M Russell, Michael Stowasser, Peter J Fuller, Jun Yang
BACKGROUND: Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS: We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022...
December 14, 2023: Hypertension
https://read.qxmd.com/read/38090987/mineralocorticoid-receptor-antagonism-by-eplerenone-and-arterial-inflammation-in-hiv-the-mirabella-hiv-study
#40
RANDOMIZED CONTROLLED TRIAL
Suman Srinivasa, Shady Abohashem, Allie R Walpert, Carolyn N Dunderdale, Sanjna Iyengar, Grace Shen, Michael Jerosch-Herold, Christopher R deFilippi, Gregory K Robbins, Hang Lee, Raymond Y Kwong, Gail K Adler, Ahmed Tawakol, Steven K Grinspoon
IMPORTANCE: The risk for atherosclerotic disease is increased 1.5- to 2.0-fold among persons with HIV (PWH). Increased activation of the renin-angiotensin-aldosterone system may contribute to increased arterial inflammation in this population. OBJECTIVE: To determine the effects of eplerenone on arterial inflammation among well-treated PWH without known cardiovascular disease (CVD). DESIGN, SETTING, AND PARTICIPANTS: Well-treated PWH who participated in the double-blinded, placebo-controlled, Mineralocorticoid Receptor Antagonism for Cardiovascular Health in HIV (MIRACLE HIV) study between February 2017 and March 2022 assessing the effects of eplerenone on myocardial perfusion were invited to participate in the Mineralocorticoid Receptor Antagonism By Eplerenone to Lower Arterial Inflammation in HIV (MIRABELLA) substudy if there was no current statin use...
February 1, 2024: JAMA Cardiology
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