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The impact of superselective adrenal artery embolization on renal function in patients with primary aldosteronism: a prospective cohort study

Hypertension Research volume 47, pages 944–958 (2024)Cite this article

Abstract

Superselective adrenal artery embolization (SAAE) is an effective treatment for patients with primary aldosteronism (PA). However, the impact of SAAE on renal function in the PA population remains uncertain. We investigated the estimated glomerular filtration rate (eGFR) and age, sex, body mass index, and diabetes-specific percentiles of eGFR residuals in 182 PA patients treated with SAAE in a prospective cohort from Nanchang SAAE in treating PA registry study. Data suggest that SAAE caused a significant decrease in eGFR from 91.9 ± 26.1 to 88.7 ± 24.1 ml/min/1.73 m2 (p < 0.05) after a median follow-up of 8 months in PA patients. Patients experienced a significant decrease in eGFR from 110.6 ± 18.9 to 103.8 ± 18.2 ml/min/1.73 m2 (p < 0.001) and a very slight increase from 71.1 ± 14.8 to 71.8 ± 17.8 ml/min/1.73 m2 (p = 0.770) with baseline eGFR ≥90 and <90 ml/min/1.73 m2, respectively. Patients with high eGFR residuals (glomerular hyperfiltration) experienced a significant decrease in their eGFR levels from 123.1 ± 22.6 to 105.0 ± 18.6 ml/min/1.73 m2 (p < 0.001). In contrast, there was no significant impact of SAAE on the eGFR of patients with normal or low eGFR residuals. The very early eGFR changes (24 h after SAAE) best predicted the effect of SAAE on eGFR changes after median of eight months in PA patients. On the whole, SAAE seems to have a beneficial impact on renal function in patients with PA, the results of which vary depending on the patient’s baseline eGFR and glomerular hyperfiltration status.

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Funding

Funding

The present study was funded by the National Natural Science Foundation of China (81960088).

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  1. These authors contributed equally: Ze-Qun Lai and Yang Fu

Authors and Affiliations

  1. Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China

    Ze-Qun Lai, Yang Fu, Jian-Wei Liu, Hong-Jin Zhang, Huang Zhang, Ning-Peng Liang & Yi-Fei Dong

  2. Jiangxi Key Laboratory of Molecular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, China

    Yi-Fei Dong

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Lai, ZQ., Fu, Y., Liu, JW. et al. The impact of superselective adrenal artery embolization on renal function in patients with primary aldosteronism: a prospective cohort study. Hypertens Res 47, 944–958 (2024). https://doi.org/10.1038/s41440-023-01503-8

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