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Reincke, M.* ; Rump, L.C.* ; Quinkler, M.* ; Hahner, S.* ; Diederich, S.* ; Lorenz, R.* ; Seufert, J.* ; Schirpenbach, C.* ; Beuschlein, F.* ; Bidlingmaier, M.* ; Meisinger, C. ; Holle, R. ; Endres, S.*

Risk factors associated with a low glomerular filtration rate in primary aldosteronism.

J. Clin. Endocrinol. Metab. 94, 869-875 (2009)
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Context: Primary aldosteronism (PA) is associated with vascular end organ damage. Objective: We evaluated the newly established German Conn's Registry for evidence of renal impairment and compared the data with those from hypertensive subjects of a population-based survey. Design: We conducted a case-control study. Patients and Controls: A total of 408 patients with PA from the Conn's registry treated in five German centers were matched for age, sex, and body mass index in a 1:1 ratio with 408 hypertensive control subjects from the population-based F3 survey of the Kooperative Gesundheitsforschung in the region of Augsburg (KORA). Main Outcome Measures: We measured serum creatinine and calculated glomerular filtration rate (GFR). Results: The percentage of patients with a serum creatinine concentration above the normal range of 1.25 mg/dl was higher in patients with PA than in hypertensive controls (29 vs. 10%; P < 0.001). Regression analysis showed that age, male sex, low potassium, and high aldosterone concentrations were independent predictors of a lower GFR. Adrenalectomy reduced systolic blood pressure from a mean of 160 to 144 mm Hg. In parallel, we observed an increase in serum creatinine and a decrease of GFR from 71 to 64 ml/min (P < 0.001). A similar trend was seen after spironolactone treatment. Conclusions: In a large cohort of patients with PA, markers of disease activity such as plasma aldosterone and serum potassium are independent predictors of a lower GFR. Specific interventions, such as adrenalectomy or spironolactone treatment, are associated with a further decline in GFR.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter renal-function; mineralocorticoids; diagnosis; escape; damage
ISSN (print) / ISBN 0021-972X
e-ISSN 1945-7197
Zeitschrift Journal of Clinical Endocrinology & Metabolism, The
Quellenangaben Band: 94, Heft: 3, Seiten: 869-875 Artikelnummer: , Supplement: ,
Verlag Endocrine Society
Verlagsort Bethesda, Md.
Begutachtungsstatus