Long‐term effects of primary aldosteronism treatment on patients with primary aldosteronism and chronic kidney disease
Authors' conclusion
Our study suggests that treatment of PA in stage 3 CKD is safe and useful in preventing renal injury.
Study context
- Population
- Patients with primary aldosteronism (PA), including those with post-treatment chronic kidney disease (CKD) (estimated GFR (eGFR) < 60 ml/min/1.73 m²)49 with post-treatment CKD
- Participants
- 107 patients
- Exposure
- ADX vs mineralocorticoid receptor antagonist (MRA) in PA with post-treatment CKD
- ADXn = 31
- MRAn = 18
- Outcome
- Reduction in eGFR 1 month after treatment, CKD group
- Follow-up
- 1 month
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
ADX
−20.1
mean · ± 8.2 · ml/min/1.73 m²
MRA
−9.2
mean · ± 5.9 · ml/min/1.73 m²
Observational data: associations, not effects.
Further findings
| Outcome | ADXn = 12 | MRAn = 8 |
|---|---|---|
| Long-term eGFR in CKD patients followed >5 years | n = 12 | n = 8 |
- Long-term eGFR in CKD patients followed >5 years: 20 patients with CKD
Predictors of acute eGFR reduction
- After ADX: pre-treatment eGFR and plasma aldosterone concentration were independent predictors (multivariate analysis)
- After MRA: duration of hypertension and pre-treatment eGFR were independent predictors (multivariate analysis)
Long-term eGFR in CKD patients followed >5 years
- No further significant decline in eGFR, nor any difference between the two treatment modalities
Original publication
Long‐term effects of primary aldosteronism treatment on patients with primary aldosteronism and chronic kidney disease. Clin Endocrinol (Oxf). Published 17 November 2022. doi:10.
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