Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism

JPAS and JRAS groups

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)339-350
Number of pages12
JournalEuropean journal of endocrinology
Volume181
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

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Hyperaldosteronism
Aldosterone
Kidney
Glomerular Filtration Rate
Proteinuria
Logistic Models
Regression Analysis
Cardiovascular System
Myocardial Ischemia
Japan
Cross-Sectional Studies
Stroke
Databases
Blood Pressure
Hypertension

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism. / JPAS and JRAS groups.

In: European journal of endocrinology, Vol. 181, No. 3, 01.01.2019, p. 339-350.

Research output: Contribution to journalArticle

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title = "Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism",
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.",
author = "{JPAS and JRAS groups} and Akiyuki Kawashima and Masakatsu Sone and Nobuya Inagaki and Yoshiyu Takeda and Hiroshi Itoh and Isao Kurihara and Hironobu Umakoshi and Takamasa Ichijo and Takuyuki Katabami and Norio Wada and Yoshihiro Ogawa and Junji Kawashima and Megumi Fujita and Shozo Miyauchi and Shintaro Okamura and Tomikazu Fukuoka and Toshihiko Yanase and Shoichiro Izawa and Yuichiro Yoshikawa and Shigeatsu Hashimoto and Masanobu Yamada and Tatsuya Kai and Tomoko Suzuki and Mitsuhide Naruse",
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T1 - Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism

AU - JPAS and JRAS groups

AU - Kawashima, Akiyuki

AU - Sone, Masakatsu

AU - Inagaki, Nobuya

AU - Takeda, Yoshiyu

AU - Itoh, Hiroshi

AU - Kurihara, Isao

AU - Umakoshi, Hironobu

AU - Ichijo, Takamasa

AU - Katabami, Takuyuki

AU - Wada, Norio

AU - Ogawa, Yoshihiro

AU - Kawashima, Junji

AU - Fujita, Megumi

AU - Miyauchi, Shozo

AU - Okamura, Shintaro

AU - Fukuoka, Tomikazu

AU - Yanase, Toshihiko

AU - Izawa, Shoichiro

AU - Yoshikawa, Yuichiro

AU - Hashimoto, Shigeatsu

AU - Yamada, Masanobu

AU - Kai, Tatsuya

AU - Suzuki, Tomoko

AU - Naruse, Mitsuhide

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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