Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism. / Mørup, Sara; Voss, Nathalie; Feltoft, Claus Larsen; Andreassen, Mikkel; Krogh, Jesper.

In: Clinical Endocrinology, Vol. 96, No. 6, 2022, p. 793-802.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Mørup, S, Voss, N, Feltoft, CL, Andreassen, M & Krogh, J 2022, 'Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism', Clinical Endocrinology, vol. 96, no. 6, pp. 793-802. https://doi.org/10.1111/cen.14678

APA

Mørup, S., Voss, N., Feltoft, C. L., Andreassen, M., & Krogh, J. (2022). Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism. Clinical Endocrinology, 96(6), 793-802. https://doi.org/10.1111/cen.14678

Vancouver

Mørup S, Voss N, Feltoft CL, Andreassen M, Krogh J. Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism. Clinical Endocrinology. 2022;96(6):793-802. https://doi.org/10.1111/cen.14678

Author

Mørup, Sara ; Voss, Nathalie ; Feltoft, Claus Larsen ; Andreassen, Mikkel ; Krogh, Jesper. / Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism. In: Clinical Endocrinology. 2022 ; Vol. 96, No. 6. pp. 793-802.

Bibtex

@article{062ee345d5044a79b200fc3a0dd3f0db,

title = "Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism",

abstract = "Objective: Primary aldosteronism (PA) is the most common cause of endocrine hypertension and adrenalectomy is the firstline treatment for unilateral PA. Suppression of aldosterone secretion of the nondominant adrenal gland at adrenal venous sampling (AVS), that is, contralateral suppression (CLS) has been suggested as a marker of disease severity. However, whether factors such as CLS, age, gender or comorbidities are associated with remission after surgery is controversial. The objective of this study is to investigate the prognostic value of CLS, age, gender, aldosterone-to-renin ratio, antihypertensives and comorbidities for clinical and biochemical remission following unilateral adrenalectomy in patients with PA. Design and patients: A retrospective study of patients with PA referred for AVS at Rigshospitalet from May 2011 to September 2020, who subsequently underwent adrenalectomy. Clinical remission was defined according to the PA surgical outcome criteria, whereas complete biochemical remission was defined as normalization of hypokalaemia without potassium substitution. Results: Eighty-four patients were available for analysis of primary outcome. Among patients with CLS, 28/58 (48.3%) obtained complete clinical remission after surgery compared with 10/26 (38.5%) without CLS (p =.40). Complete biochemical remission was obtained in 55/58 (94.8%) of patients with CLS compared with 25/28 (89.3%) without CLS (p =.44). Female gender and lower number of antihypertensives at baseline were associated with higher odds for complete clinical remission, whereas none of the investigated variables were associated with biochemical remission. Conclusion: CLS was not significantly associated with complete clinical or biochemical remission in this cohort. Our results confirmed that female gender and lower number of antihypertensives were predictors of clinical remission.",

keywords = "biochemical remission, clinical remission, contralateral suppression, contralateral suppression index, hyperaldosteronism, PASO, primary aldosteronism",

author = "Sara M{\o}rup and Nathalie Voss and Feltoft, {Claus Larsen} and Mikkel Andreassen and Jesper Krogh",

note = "Publisher Copyright: {\textcopyright} 2022 John Wiley & Sons Ltd.",

year = "2022",

doi = "10.1111/cen.14678",

language = "English",

volume = "96",

pages = "793--802",

journal = "Clinical Endocrinology",

issn = "0300-0664",

publisher = "Wiley-Blackwell",

number = "6",

}

RIS

TY - JOUR

T1 - Prognostic value of contralateral suppression for remission after surgery in patients with primary aldosteronism

AU - Mørup, Sara

AU - Voss, Nathalie

AU - Feltoft, Claus Larsen

AU - Andreassen, Mikkel

AU - Krogh, Jesper

PY - 2022

Y1 - 2022

N2 - Objective: Primary aldosteronism (PA) is the most common cause of endocrine hypertension and adrenalectomy is the firstline treatment for unilateral PA. Suppression of aldosterone secretion of the nondominant adrenal gland at adrenal venous sampling (AVS), that is, contralateral suppression (CLS) has been suggested as a marker of disease severity. However, whether factors such as CLS, age, gender or comorbidities are associated with remission after surgery is controversial. The objective of this study is to investigate the prognostic value of CLS, age, gender, aldosterone-to-renin ratio, antihypertensives and comorbidities for clinical and biochemical remission following unilateral adrenalectomy in patients with PA. Design and patients: A retrospective study of patients with PA referred for AVS at Rigshospitalet from May 2011 to September 2020, who subsequently underwent adrenalectomy. Clinical remission was defined according to the PA surgical outcome criteria, whereas complete biochemical remission was defined as normalization of hypokalaemia without potassium substitution. Results: Eighty-four patients were available for analysis of primary outcome. Among patients with CLS, 28/58 (48.3%) obtained complete clinical remission after surgery compared with 10/26 (38.5%) without CLS (p =.40). Complete biochemical remission was obtained in 55/58 (94.8%) of patients with CLS compared with 25/28 (89.3%) without CLS (p =.44). Female gender and lower number of antihypertensives at baseline were associated with higher odds for complete clinical remission, whereas none of the investigated variables were associated with biochemical remission. Conclusion: CLS was not significantly associated with complete clinical or biochemical remission in this cohort. Our results confirmed that female gender and lower number of antihypertensives were predictors of clinical remission.

AB - Objective: Primary aldosteronism (PA) is the most common cause of endocrine hypertension and adrenalectomy is the firstline treatment for unilateral PA. Suppression of aldosterone secretion of the nondominant adrenal gland at adrenal venous sampling (AVS), that is, contralateral suppression (CLS) has been suggested as a marker of disease severity. However, whether factors such as CLS, age, gender or comorbidities are associated with remission after surgery is controversial. The objective of this study is to investigate the prognostic value of CLS, age, gender, aldosterone-to-renin ratio, antihypertensives and comorbidities for clinical and biochemical remission following unilateral adrenalectomy in patients with PA. Design and patients: A retrospective study of patients with PA referred for AVS at Rigshospitalet from May 2011 to September 2020, who subsequently underwent adrenalectomy. Clinical remission was defined according to the PA surgical outcome criteria, whereas complete biochemical remission was defined as normalization of hypokalaemia without potassium substitution. Results: Eighty-four patients were available for analysis of primary outcome. Among patients with CLS, 28/58 (48.3%) obtained complete clinical remission after surgery compared with 10/26 (38.5%) without CLS (p =.40). Complete biochemical remission was obtained in 55/58 (94.8%) of patients with CLS compared with 25/28 (89.3%) without CLS (p =.44). Female gender and lower number of antihypertensives at baseline were associated with higher odds for complete clinical remission, whereas none of the investigated variables were associated with biochemical remission. Conclusion: CLS was not significantly associated with complete clinical or biochemical remission in this cohort. Our results confirmed that female gender and lower number of antihypertensives were predictors of clinical remission.

KW - biochemical remission

KW - clinical remission

KW - contralateral suppression

KW - contralateral suppression index

KW - hyperaldosteronism

KW - PASO

KW - primary aldosteronism

U2 - 10.1111/cen.14678

DO - 10.1111/cen.14678

M3 - Journal article

C2 - 35060161

AN - SCOPUS:85124602357

VL - 96

SP - 793

EP - 802

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 6

ER -

ID: 308163134