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논문분류	춘계학술대회 초록집
제목	Glomerular filtration rate declines after adrenalectomy in patients with primary aldosteronism: identification of predictors for decreased renal function.
저자	Il Young Kim* 1, Joo Hui Kim1, Harin Rhee2, Sang Heon Song2, Eun Young Seong2, Dong Won Lee1, Soo Bong Lee1, Ihm Soo Kwak2
출판정보	2016; 2016(1):
키워드	adrenalectomy, primary aldosteronism, Renal function
초록	Background: Glomerular filtration rate (GFR) has been reported to decrease after unilateral adrenalectomy in patients with primary aldosteronism (PA). The aim of this study was to identify clinical predictors for decreased GFR after adrenalectomy in patients with PA. Methods: The records of 187 patients (98 patients with PA and 89 patients with non-PA adrenal disease) who were followed for 6 months after unilateral adrenalectomy were retrospectively analyzed. Estimated GFR (eGFR) was investigated at 1, 3, and 6 months after surgery. Pre-operative predictors for eGFR % decrement at 1 month [(pre-operative eGFR - eGFR at 1 month)/pre-operative eGFR] were investigated. Results: In baseline characteristics, PA group showed higher levels of systolic/diastolic blood pressure (SBP/DBP), aldosterone to renin ratio (ARR), and lower levels of potassium than non-PA group. The eGFR decreased significantly at 1 month (P < 0.001) and remained stable in PA group. However, there were no significant changes of eGFR in non-PA group throughout 6 months. In PA group, univariate analysis showed that SBP (r = 0.291, P = 0.004), DBP (r = 0.359, P < 0.001), ARR (r = 0.572, P < 0.001), and pre-operative eGFR (r = 0.309, P = 0.002) correlated with eGFR % decrement at 1 month. Multiple linear regression analysis revealed that higher pre-operative eGFR (β = 0.286, P = 0.001) and ARR (β = 0.464, P < 0.001) were independent predictors for eGFR % decrement at 1 month. Conclusion: Renal function seems to deteriorate significantly after unilateral adrenalectomy in patients with PA. Clinicians need to pay attention to post-operative renal function in patients with PA, particularly who showed higher pre-operative eGFR and ARR.
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