Renal function after adrenalectomy in patients with primary aldosteronism

Area of Science:

• Endocrinology
• Nephrology
• Surgical Oncology

Background:

• Unilateral primary aldosteronism is often treated with adrenalectomy.
• Postoperative renal function changes after adrenalectomy are not well understood.

Purpose of the Study:

• To evaluate renal function after adrenalectomy for unilateral primary aldosteronism.
• To identify risk factors associated with a decline in renal function.

Main Methods:

• Retrospective study of 107 adults undergoing adrenalectomy for unilateral primary aldosteronism.
• Estimated glomerular filtration rate (eGFR) change calculated pre- and post-surgery.
• Logistic regression used to assess factors linked to eGFR decline.

Main Results:

• A significant decline in eGFR was observed post-adrenalectomy, with median declines of 18.2% at 1 month and 20% at 12 months.
• Among patients with baseline eGFR ≥60, 32.5% dropped below 60 mL/min/1.73 m² at 12 months.
• Older age, a lateralization index >30, and a 1-month eGFR decline <60 were associated with a 12-month eGFR decline <60.

Conclusions:

• Adrenalectomy for unilateral primary aldosteronism leads to a notable decrease in estimated glomerular filtration rate.
• Patients should be informed about the high probability of unmasked renal impairment.
• Regular eGFR monitoring is recommended for all patients post-adrenalectomy.