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Renal damage in primary aldosteronism: results of the PAPY Study

Gian Paolo Rossi1, Giampaolo Bernini, Giovambattista Desideri

  • 1Department of Clinical and Experimental Medicine, Clinica Medica 4, University Hospital, via Giustiniani, 2, 35126 Padova, Italy. gianpaolo.rossi@unipd.it

Hypertension (Dallas, Tex. : 1979)
|June 28, 2006
PubMed

Insights

Primary aldosteronism, caused by aldosterone-producing adenoma or idiopathic hyperaldosteronism, leads to early kidney damage, indicated by higher albuminuria, compared to primary hypertension. This highlights the renal impact of excess aldosterone secretion.

Area of Science:

  • Nephrology
  • Endocrinology
  • Hypertension Research

Background:

  • Primary aldosteronism (PA) is linked to cardiovascular issues, but its kidney effects are less understood.
  • It's unclear if kidney involvement differs between aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA).

Purpose of the Study:

  • To investigate renal damage signs in patients with PA (APA and IHA) versus primary hypertension (PH).
  • To assess differences in kidney involvement between APA, IHA, and PH.

Main Methods:

  • Prospective survey (PAPY Study) of 1180 newly diagnosed hypertension patients.
  • Renal damage assessed by 24-hour urine albumin excretion (UAE) and glomerular filtration rate (GFR).
  • Analysis included body mass index, age, urinary electrolytes, serum potassium, and blood pressure.

Main Results:

  • Of 490 patients with normal GFR, 31 had APA, 33 had IHA, and 426 had PH.
  • Covariate-adjusted UAE was significantly higher in APA and IHA patients compared to PH patients.
  • Microalbuminuria was more prevalent in APA and IHA groups than in the PH group.

Conclusions:

  • Hypertension due to excess aldosterone secretion (PA) shows earlier and more prominent renal damage than primary hypertension.
  • Patients with APA or IHA exhibit higher urine albumin excretion rates than comparable PH patients, even with preserved GFR.

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