RENAL DAMAGE IN PRIMARY ALDOSTERONISM

• DOI: 10.1097/01.hjh.0000570648.58464.93
• Publication Date: 2019-06-22T17:23:13Z
• Authors: S. Monticone; E. Sconfienza; F. D’Ascenzo; F. Buffolo; F. Satoh; C. Catena; F. Veglio; P. Mulatero
• Keywords: Primary Aldosteronism; Albuminuria

Objective: In experimental animal models a significant association between exogenous aldosterone excess and the progression of renal disease has been observed. However, evidence an increased risk damage in patients affected by primary aldosteronism (PA) remains controversial. We aimed to assess relationship PA, target organ its reversibility, synthesizing available from prospective retrospective observational studies, through meta-analysis. Design method: searched MEDLINE, EMBASE, Cochrane Central Register Controlled Trials January 1960 up August 2017. Forty-four studies including 4,438 with PA 8,234 non-PA arterial hypertension were eligible for this 14 out 44 different degree impairment excluded analysis purpose two subgroups have generated (i.e. “Renal excluded” not excluded”). Results: After 8.5 years diagnosis hypertension, glomerular filtration rate (GFR) was significantly higher overall population (by 3.93 ml/min IQR [0.60; 7.26]). Of note, subgroup indicated that difference GFR only those included 5.69 [1.15; 10.22]), while when considering which excluded, mean populations. Similarly, more severe albuminuria (Std. 0.57 [0.11–1.03]), resulting into microalbuminuria (OR 2.15 [1.21; 3.84]) observed PA. Following specific treatment, after median follow-up 12 months, reduction −10.57 [−13.60; −7.55]) consistent both surgically medically treated patients. Consistently, albumin excretion increase serum creatinine treatment. Conclusions: The results present meta-analysis further emphasize importance early since patients, compared hypertensive display pronounced damage, can be at least partly reverted