Age, Gender, and Body Mass Index as Determinants of Surgical Outcome in Primary Aldosteronism
Horm Metab Res DOI: 10.1055/a-1139-1783Although unilateral primary aldosteronism (PA) should be curable by adrenalectomy
(ADX), postsurgical outcome is affected by several clinical factors. Herein we
reviewe the importance of age, gender, and BMI as determinants of surgical
success based on the recent findings including a nation-wide, multicenter study
in Japan (JPAS/JRAS). It is important to determine whether ADX for
elderly patients with unilateral PA is as beneficial as younger patients.
JPAS/JRAS showed that ADX could benefit elderly patients (>65
years) with definitive unilateral PA in curing of disease and improvement of
hypertension, although potential adverse outcomes including hyperkalemia and
renal insufficiency need to be considered in some elderly patients at high risk.
As shown in previous studies, JPAS/JRAS also demonstrated that female
gender was an independent predictor for clinical cure after ADX in patients with
unilateral PA. The gender-specific predominance of somatic mutations of
aldosterone-producing adenoma and sex hormones with vasculo-protective effects
might account for the difference of surgical outcome between genders.
Additionally, lower body mass index (BMI) has been shown to be one of the
predictive factors for better clinical outcome after ADX. The relation between
BMI and s...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Naruse, Mitsuhide Yamamoto, Koichi Katabami, Takuyuki Nakamaru, Ryo Sone, Masakatsu Kobayashi, Hiroki Tanabe, Akiyo Tags: Review Source Type: research