Treatable glomerular hyperfiltration in patients with active acromegaly.

Area of Science:

• Endocrinology
• Nephrology
• Neurosurgery

Background:

• Active acromegaly is associated with an elevated glomerular filtration rate (GFR).
• The long-term effects of acromegaly on renal function and the reversibility of these changes after treatment are not fully understood.

Purpose of the Study:

• To investigate whether renal function deteriorates in acromegaly patients after surgical remission.
• To determine if any observed deterioration in renal function is reversible.

Main Methods:

• A case-control study comparing 48 surgically cured acromegaly patients with 48 controls with nonfunctioning pituitary adenomas (NFomas).
• Clinical and biochemical examinations, including estimated GFR (eGFR) calculation, were performed pre- and post-surgery (3 months).
• Postoperative changes in eGFR were assessed in both groups.

Main Results:

• Preoperative eGFR was significantly higher in acromegaly patients (99.8 mL/min) than in NFoma controls (75.1 mL/min).
• Acromegaly patients experienced a significant eGFR decline post-surgery (99.8 to 86.2 mL/min), unlike NFoma patients (75.1 to 81.9 mL/min).
• The eGFR decrease was more pronounced in acromegalic patients with higher preoperative eGFR.

Conclusions:

• Surgical remission in acromegaly leads to a significant decrease in eGFR, which is not observed in NFoma patients.
• The eGFR decline is reversible in acromegalic patients with high/normal preoperative eGFR, indicating functional changes.
• In acromegaly patients with low preoperative eGFR, the decline may represent irreversible organic changes.