Unilateral adrenalectomy improves urinary protein excretion but does not abolish its relationship to sodium excretion in patients with aldosterone-producing adenoma

Pimenta, E., Gordon, R. and Stowasser, M. (2010). Unilateral adrenalectomy improves urinary protein excretion but does not abolish its relationship to sodium excretion in patients with aldosterone-producing adenoma. In: John E. Hall, Hypertension. Abstracts from the 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia. HBPRCA 2009 ASM: 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia, Sydney, NSW, Australia, (1507-1507). 1-3 December 2009. doi:10.1161/HYP.0b013e3181df4279


Author Pimenta, E.
Gordon, R.
Stowasser, M.
Title of paper Unilateral adrenalectomy improves urinary protein excretion but does not abolish its relationship to sodium excretion in patients with aldosterone-producing adenoma
Conference name HBPRCA 2009 ASM: 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia
Conference location Sydney, NSW, Australia
Conference dates 1-3 December 2009
Proceedings title Hypertension. Abstracts from the 31st Annual Scientific Meeting of the High Blood Pressure Research Council of Australia   Check publisher's open access policy
Journal name Hypertension   Check publisher's open access policy
Place of Publication Baltimore, MD, U.S.A.
Publisher Lippincott Williams & Wilkins for the American Heart Association
Publication Year 2010
Year available 2009
DOI 10.1161/HYP.0b013e3181df4279
ISSN 0194-911X
1524-4563
0073-425X
Editor John E. Hall
Volume 55
Issue 6
Start page 1507
End page 1507
Total pages 1
Language eng
Formatted Abstract/Summary
Experimental and human data suggest that the cardiorenal effects of aldosterone excess are dependent upon concomitant dietary salt intake. Increased urinary protein (Uprot) is an early sign of nephropathy independently associated with cardiovascular risk. In a previous study we demonstrated that there is a positive association between Uprot and urinary sodium (UNa) in patients with hyperaldosteronism, but not in patients with normal aldosterone levels. The objective of the current study was to determine if Uprot is related to UNa in patients with aldosterone-producing adenoma (APA) and whether the degree of Uprot and strength of this relationship is reduced following correction of hyperaldosteronism by unilateral adrenalectomy. Subjects with APA (n=26) underwent measurement of Uprot and UNa in 24h urinary collections before and after adrenalectomy (follow up duration 15.3±12.4 months). Following surgery, mean clinic blood pressure (BP) fell (from 151.7±19.8/89.5±13.3 to 134.5±14.5/83.4±12.9 mm Hg, P=0.0005 for systolic BP), despite a significant fall in number of antihypertensive medications (from 1.9±1.2 to 0.7±1.1; P<0.0001). Uprot and urinary volume decreased after adrenalectomy (from 201.2±98.3 to 106.8±37.1 mg/day; P<0.0001 and from 2484.4±854.2 to 2005.3±716.4 ml/day; P=0.0005). There was a positive correlation between Uprot/creatinine ratio and UNa/creatinine ratio both before (r=0.41, P=0.0361) and after (r=0.44, P=0.0242) adrenalectomy. Unilateral adrenalectomy reduces proteinuria in patients with APA. The rapid response in some patients is consistent with a role for hyperfiltration in its etiology. A positive relationship between urinary protein and sodium excretion exists not only before adrenalectomy, but also after surgery. One explanation for this persisting relationship could be long term renal exposure to hyperaldosteronism resulting in glomerular damage and an ongoing tendency to salt-sensitive protein excretion. These findings suggest that both high aldosterone levels and higher dietary salt intakes could contribute to increased cardiovascular risk in these patients.
Subjects 1103 Clinical Sciences
Keyword Aldosterone
Salt
Proteinuria
Kidney
Q-Index Code EX
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published as Abstract 070.

Document type: Conference Paper
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Created: Sun, 29 Aug 2010, 00:05:53 EST