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Higher risk of chronic kidney disease and progressive kidney function impairment in primary aldosteronism than in

María Fernández-Argüeso1, Eider Pascual-Corrales1, Nuria Bengoa Rojano1

  • 1Endocrinology and Nutrition Department, Ramón y Cajal University Hospital & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain.

Endocrine
|April 2, 2021
PubMed

Insights

Primary aldosteronism (PA) patients show higher chronic kidney disease (CKD) prevalence at diagnosis than essential hypertension (EH) patients. PA also carries a greater risk of kidney function decline, irrespective of blood pressure control.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiology

Background:

  • Primary aldosteronism (PA) is a significant cause of secondary hypertension.
  • Cardiometabolic comorbidities are common in hypertensive patients.
  • Understanding differences between PA and essential hypertension (EH) is crucial for patient management.

Purpose of the Study:

  • To compare the prevalence, risk, and control of cardiometabolic comorbidities in PA versus EH patients.
  • To assess kidney function decline in PA compared to EH.

Main Methods:

  • A case-control study matched PA patients with EH patients by age, sex, and blood pressure.
  • Data collected included prevalence of comorbidities and kidney function (eGFR).
  • Follow-up analysis assessed changes in kidney function and comorbidity development.

Main Results:

  • PA patients had a higher prevalence of chronic kidney disease (CKD) at diagnosis (18.4% vs. 2.1%).
  • No significant differences in other comorbidities or their control were observed initially.
  • Over follow-up, PA patients showed a significantly greater decline in kidney function (-17.6 vs. -2.8 mL/min/1.73 m²/year).

Conclusions:

  • PA is associated with a higher prevalence of CKD at diagnosis compared to EH.
  • PA patients face a substantially increased risk of kidney function impairment during follow-up.
  • This kidney function decline in PA is independent of blood pressure control levels.
Abstract

Keywords:
Cardiometabolic profileChronic kidney diseaseEssential hypertensionPrimary aldosteronism

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