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Hyperaldosteronism

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https://www.readbyqxmd.com/read/28228887/transarterial-embolization-of-a-hyperfunctioning-aldosteronoma-in-a-patient-with-bilateral-adrenal-nodules
#1
Jason T Salsamendi, Francisco J Gortes, Alejandro R Ayala, Juan D Palacios, Sanjit Tewari, Govindarajan Narayanan
Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. The patient presented with a cerebrovascular accident, and subsequently developed uncontrolled hypertension, hypokalemia, and a myocardial infarction...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28224279/np-59-test-for-preoperative-localization-of-primary-hyperaldosteronism
#2
Marcello Di Martino, Iñigo García Sanz, Jose Luis Muñoz de Nova, Cristina Marín Campos, Miguel Martínez Martín, Luis Domínguez Gadea
PURPOSE: Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases. METHODS: Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. When nuclear medicine tests were preoperatively performed, their results were compared with the histopathologic findings and clinical improvement...
February 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28211216/low-dose-eplerenone-treatment-decreases-aortic-stiffness-in-patients-with-resistant-hypertension
#3
Tatjana Kalizki, Bernhard M W Schmidt, Ulrike Raff, Annemarie Reinold, Thomas K Schwarz, Markus P Schneider, Roland E Schmieder, Andreas Schneider
Vascular damage is aggravated in animal models of hypertension with mineralocorticoid (MR) excess and in hypertensive patients with primary hyperaldosteronism. MR antagonism has shown to provide effective blood pressure (BP)-control in patients with treatment resistant hypertension (TRH), but the concurrent effects on the vasculature have not been examined. In a randomized, double-blinded, placebo-controlled parallel-group study, 51 patients with TRH received either eplerenone 50 mg or placebo for 6 months together with additional antihypertensives titrated to achieve a BP target of <140/90 mm Hg...
February 17, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28111697/assessment-of-the-aldosteronona-resolution-score-as-a-predictive-resolution-score-of-hypertension-after-adrenalectomy-for-aldosteronoma-in-french-patients
#4
Ludwig Pasquier, Medhi Kirouani, Florian Fanget, Claire Nomine, Cécile Caillard, Vincent Arnault, Jean-Baptiste Finel, Niki Christou, Muriel Mathonnet, Christophe Trésallet, Antoine Hamy, Loïc de Calan, Laurent Brunaud, Fabrice Menegaux, Jean Christophe Lifante, Jean Benoit Hardouin, Delphine Drui, Éric Mirallié, Claire Blanchard
PURPOSE: Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population. METHOD: Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Diagnosis of Aldosterone-producing adenoma (APA) was confirmed with clinical and biochemical hyperaldosteronism and adrenal nodule on CT scan...
January 22, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28099220/evacetrapib-another-cetp-inhibitor-for-dyslipidemia-with-no-clinical-benefit
#5
Vaughn A Eyvazian, William H Frishman
Evacetrapib is a cholesteryl ester transfer protein (CETP) inhibitor that has been recently studied as a cholesterol modifying agent to reduce cardiovascular risk and mortality in high risk cardiovascular disease patients. Evacetrapib acts to decrease lipid exchange through CETP inhibition. CETP acts to transfer cholesteryl esters from high-density lipoprotein-cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) and very-low-density lipoprotein (VLDL-C). HDL-C is involved in reverse cholesterol transport and its blood levels have been shown to be inversely correlated with cardiovascular risk...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28041953/synthetic-approaches-towards-the-multi-target-drug-spironolactone-and-its-potent-analogues-derivatives
#6
REVIEW
Fayaz Ali Larik, Aamer Saeed, Danish Shahzad, Muhammad Faisal, Hesham El-Seedi, Haroon Mehfooz, Pervaiz Ali Channar
Spironolactone is a well-known multi-target drug and is specifically used for the treatment of high blood pressure and heart failure. It is also used for the treatment of edema, cirrhosis of the liver, malignant, pediatric, nephrosis and primary hyperaldosteronism. Spironolactone in association with thiazide diuretics treats hypertension and in association with furosemide treats bronchopulmonary dyspepsia. The therapeutic mechanism of action of spironolactone involves binding to intracellular mineralocorticoids receptors (MRs) in kidney epithelial cells, thereby inhibiting the binding of aldosterone...
December 29, 2016: Steroids
https://www.readbyqxmd.com/read/28018459/a-novel-mutation-of-clcnkb-in-a-korean-patient-of-mixed-phenotype-of-bartter-gitelman-syndrome
#7
Hee-Won Cho, Sang Taek Lee, Heeyeon Cho, Hae Il Cheong
Bartter syndrome (BS) is an inherited renal tubular disorder characterized by low or normal blood pressure, hypokalemic metabolic alkalosis, and hyperreninemic hyperaldosteronism. Type III BS is caused by loss-of-function mutations in CLCNKB encoding basolateral ClC-Kb. The clinical phenotype of patients with CLCNKB mutations has been known to be highly variable, and cases that are difficult to categorize as type III BS or other hereditary tubulopathies, such as Gitelman syndrome, have been rarely reported...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28001017/improvement-of-bone-turnover-markers-and-bone-mineral-density-following-treatment-of-primary-aldosteronism
#8
Huai H Loh, Nor A Kamaruddin, Rozman Zakaria, Norlela Sukor
BACKGROUND: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension. METHODS: This was an open-label, prospective, case-controlled study, conducted over 12 months. Fifty-two consecutive patients referred for secondary hypertension were screened...
December 20, 2016: Minerva Endocrinologica
https://www.readbyqxmd.com/read/27994854/consequences-of-morbid-obesity-on-the-kidney-where-are-we-going
#9
Maruja Navarro Díaz
Obesity and morbid obesity are modifiable risk factors for the development and progression of kidney disease. Obesity has reached epidemic proportions and is currently an important health problem in Europe, so it is necessary to develop therapeutic and preventive strategies. The obesity-related glomerulopathy has been defined as a secondary form of focal segmental glomerulosclerosis, and its most characteristic feature is glomerulomegaly. The renal evolution of patients with obesity-related glomerulopathy (ORG) who have not been treated is unfavourable...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27994605/the-triad-of-sleep-apnea-hypertension-and-chronic-kidney-disease-a-spectrum-of-common-pathology
#10
REVIEW
Fahad Aziz, Kunal Chaudhary
Obstructive sleep apnea (OSA), hypertension, and chronic kidney disease (CKD) are different entities and are generally managed individually most of the time. However, CKD, OSA, and hypertension share many common risk factors and it is not uncommon to see this complex triad together. In fact, they share similar pathophysiology and have been interlinked with each other. The common pathophysiology includes chronic volume overload, hyperaldosteronism, increased sympathetic activity, endothelial dysfunction, and increased inflammatory markers...
November 2016: Cardiorenal Medicine
https://www.readbyqxmd.com/read/27967304/histopathological-classification-of-cross-sectional-image-negative-hyperaldosteronism
#11
Yuto Yamazaki, Yasuhiro Nakamura, Kei Omata, Kazue Ise, Yuta Tezuka, Yoshikiyo Ono, Ryo Morimoto, Yukinaga Nozawa, Celso E Gomez-Sanchez, Scott A Tomlins, William E Rainey, Sadayoshi Ito, Fumitoshi Satoh, Hironobu Sasano
CONTEXT: Approximately half of primary aldosteronism (PA) have clinically evident disease according to clinical (hypertension) and/or laboratory (aldosterone and renin levels) findings but do not have nodules detectable in routine cross-sectional imaging. However, the detailed histopathologic, steroidogenic and pathobiological features of cross-sectional image negative PA have not been well characterized. OBJECTIVE: Examine histopathology, steroidogenic enzyme expression and somatic mutation status of aldosterone-driver genes in adrenals from cross-sectional image negative hyperaldosteronism...
December 14, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27965370/genetic-characterization-of-a-mouse-line-with-primary-aldosteronism
#12
Luis Gustavo Perez-Rivas, Yara Rhayem, Sibylle Sabrautzki, Constanze Hantel, Birgit Rathkolb, Martin Hrabé de Angelis, Martin Reincke, Felix Beuschlein, Ariadni Spyroglou
In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism a mutagenesis screen following treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. The steroidogenic enzyme expression levels in the adrenal gland did not differ significantly among phenotypically affected and unaffected mice...
December 13, 2016: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/27927710/adrenocortical-carcinoma-an-unusual-cause-of-secondary-hypertension
#13
Daniel Veron Esquivel, Fernando Batiz, Alfonso Farias Vega, Perla A Carrillo Gonzalez
We present the case of a female patient aged 39 years who was admitted to our hospital due to hypertension, severe hypokalaemia and metabolic alkalosis; physical examination was remarkable for plethoric moon face, centripetal obesity and bilateral lower extremity oedema. She was admitted for intravenous potassium replacement and further assessment of hypertension and associated clinical findings. Laboratory testing showed increased levels of aldosterone, renin, cortisol, testosterone and androstenedione. An abdominal CT revealed a large mass in the right adrenal gland with hepatic involvement...
December 7, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27923252/evaluation-of-a-recently-established-test-for-familial-hyperaldosteronism-type-1
#14
T Dringenberg, M Sorokina, M Ehlers, G Dekomien, M Haase, E Schulze, M Quinkler, L C Rump, M Schott, H S Willenberg
No abstract text is available yet for this article.
December 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27917596/plasma-adrenocorticotropic-hormone-but-not-aldosterone-is-correlated-with-blood-pressure-in-patients-with-aldosterone-producing-adenomas
#15
Hiroki Kobayashi, Akira Haketa, Ueno Takahiro, Hiromasa Otsuka, Sho Tanaka, Yoshinari Hatanaka, Yukihiro Ikeda, Masanori Abe, Noboru Fukuda, Masayoshi Soma
Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. The authors examined the levels of aldosterone, cortisol, renin, and adrenocorticotropic hormone (ACTH) measured at 12 am, 6 am, 12 pm, and 6 pm and BP in the early morning (6 am to 7 am), late morning (9 am to 11 am), and early evening (5 pm to 7 pm)...
December 5, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27906863/bartter-s-and-gitelman-s-syndrome
#16
Hannsjörg W Seyberth, Stefanie Weber, Martin Kömhoff
PURPOSE OF REVIEW: The clinical presentations of Bartter's syndrome and Gitelman's syndrome will be reviewed including two most recently described hypokalemic salt-losing tubulopathies. By taking the quite heterogeneous presentations and the apparently different pathophysiologies as the basis, the applicability of the physiologic classification has been tested. RECENT FINDINGS: According to the physiologic approach, salt-losing tubulopathies can be divided into two major groups (with completely different tubular defects): first, disorders of the thick ascending limb of Henle's loop (loop disorders); second, disorders of the distal convolute tubule (DCT disorders)...
November 30, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27872977/hypertension-cure-following-laparoscopic-adrenalectomy-for-hyperaldosteronism-is-not-universal-trends-over-two-decades
#17
Takeshi Namekawa, Takanobu Utsumi, Tomoaki Tanaka, Mayuko Kaga, Hidekazu Nagano, Takashi Kono, Koji Kawamura, Naoto Kamiya, Takashi Imamoto, Hiroyoshi Suzuki, Tomohiko Ichikawa
BACKGROUND: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades. METHODS: This retrospective clinical study included 176 patients who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism from 1995 to 2015...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27872236/preclinical-and-early-clinical-profile-of-a-highly-selective-and-potent-oral-inhibitor-of-aldosterone-synthase-cyp11b2
#18
Katrijn Bogman, Dietmar Schwab, Marie-Laure Delporte, Giuseppe Palermo, Kurt Amrein, Susanne Mohr, Maria Cristina De Vera Mudry, Morris J Brown, Philippe Ferber
: Primary hyperaldosteronism is a common cause of resistant hypertension. Aldosterone is produced in the adrenal by aldosterone synthase (AS, encoded by the gene CYP11B2). AS shares 93% homology to 11β-hydroxylase (encoded by the gene CYP11B1), responsible for cortisol production. This homology has hitherto impeded the development of a drug, which selectively suppresses aldosterone but not cortisol production, as a new treatment for primary hyperaldosteronism. We now report the development of RO6836191 as a potent (Ki 13 nmol/L) competitive inhibitor of AS, with in vitro selectivity >100-fold over 11β-hydroxylase...
January 2017: Hypertension
https://www.readbyqxmd.com/read/27862274/risk-of-fracture-in-primary-aldosteronism-a-population-based-cohort-study
#19
Vin-Cent Wu, Chia-Hui Chang, Cheng-Yi Wang, Yen-Hung Lin, Tze-Wah Kao, Po-Chih Lin, Tzong-Shinn Chu, Yuan-Shian Chang, Likwang Chen, Kwan-Dun Wu, Shih-Chieh Jeff Chueh
Primary aldosteronism (PA) is associated with increased urinary calcium excretion and osteoporosis prevalence. We studied the long-term effect of hyperaldosterone on fracture risk and possible risk mitigation via treatments, by comparing PA patients and their essential hypertension (EH) counterparts extracted by propensity score match. We used a longitudinal population database from the Taiwan National Health Insurance, and used a validated algorithm to identify PA patients diagnosed in 1997-2010. Our sample included 2533 PA patients, including 921 patients with aldosterone-producing adenoma (APA)...
November 10, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27862131/scoring-system-for-the-diagnosis-of-bilateral-primary-aldosteronism-in-the-outpatient-setting-before-adrenal-venous-sampling
#20
Hiroki Kobayashi, Akira Haketa, Takahiro Ueno, Yukihiro Ikeda, Yoshinari Hatanaka, Sho Tanaka, Hiromasa Otsuka, Masanori Abe, Noboru Fukuda, Masayoshi Soma
OBJECTIVE: The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time-consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS. DESIGN: We retrospectively analysed 82 patients who were diagnosed with PA and underwent AVS...
November 8, 2016: Clinical Endocrinology
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