We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Chronic kidney disease score for predicting postoperative masked renal insufficiency in patients with primary aldosteronism.
- Authors
Tanase‐Nakao, Kanako; Naruse, Mitsuhide; Nanba, Kazutaka; Tsuiki, Mika; Tagami, Tetsuya; Usui, Takeshi; Okuno, Hiroshi; Shimatsu, Akira; Hashimoto, Shigeatsu; Katabami, Takuyuki; Ogo, Atsushi; Okumura, Ataru; Umakoshi, Hironobu; Suzuki, Tomoko
- Abstract
Context Chronic kidney disease ( CKD) is sometimes unmasked after unilateral adrenalectomy in patients with primary aldosteronism ( PA) without expectation. Objective Our study aim was to elucidate factors responsible for developing postoperative CKD and to provide a simple scoring system to predict postoperative CKD in PA. Design and Patients Forty-five patients with PA treated with unilateral adrenalectomy and followed for at least 1 month postsurgery were studied. Thirty-one patients with non-PA adrenal disease who underwent unilateral adrenalectomy were also studied as control. Patients with pre-operative estimated glomerular filtration rate (e GFR) < 60 ml/min/1·73 m2 were excluded from both groups. Results A statistically significant ( P < 0·001) decrease in eGFR was observed in PA group within 1 month of surgery, then stabilized. Of the 45 patients with PA, 17 (37·8%) developed CKD after surgery. None of the non-PA group developed CKD after surgery. Of the pre-operative variables, logistic regression analysis showed that lower eGFR and higher aldosterone-to-renin ratios (ARR) were the independent predictors for postoperative CKD in PA. Optimal cut-off values of the two variables analysed with ROC curves were as follows: e GFR ≤ 76·9 ml/min/1·73 m2 and ARR ≥ 305. Using these data, we created a CKD score as a tool for predicting postoperative CKD, with an AUC for the score of 0·8866. Conclusion The pre-operative e GFR and ARR were the significant contributing factors for postoperative CKD in PA. By combining these independent factors, we created a CKD score which provides useful information before surgery about the risk for development of postoperative CKD.
- Subjects
KIDNEY disease diagnosis; ADRENALECTOMY; TEST scoring; HYPERALDOSTERONISM; SURGICAL complications; PATIENTS
- Publication
Clinical Endocrinology, 2014, Vol 81, Issue 5, p665
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/cen.12497