Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia · 2007
[Our experience in primary hyperaldosteronism].
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Gallego S, Covarsí A, Luengo J, González P, Suárez M A, Novillo R
Аннотация
UNLABELLED: The aim of this paper is to analyze the ways of appearance, clinical characteristics, diagnosis and treatment related to patients suffering from primary hyperaldosteronism (HA1 masculine) in external nephrology consultation since their opening.
METHODOLOGY: a retrospective study was carried out, checking out all HA1 masculine diagnosed patients of clinical records from 1981-2005.
RESULTS: 35 patients were diagnosed, with an average age of 50 and a predominance of men (82%). The main reason for starting the HA1 masculine study was persistent hypertension; other reasons were hypertension and hypopotassemia (34%). Sixteen of the cases were adenomas (7 classic adenomas and 9 renin-dependents) and fourteen of them were hyperplasia (10 bilateral hyperplasias and 4 primary adrenals hyperplasia). Five cases were excluded because they were waiting for complementary tests. For location diagnosis, gammagrafía I131cholesterol was the test showing more agreement with final diagnosis, and then RMN and TAC. In eight of the cases, an adrenal vein sampling was made. Ten of sixteen adenomas suffered a surgery performance. The result showed standardization of tensional levels, without any treatment in 60% of the cases. The rest of them are currently treated with spironolactone under an appropriate tensional control. Gynecomastia was the most usual adverse effect found.
CONCLUSION: Contrary to other published papers, we found out a male predominance in our database. A similar incidence of adenomas e hyperplasias was obtained. The most usual way of appearance was persistent hypertension to treatment. Adenomas surgery does not imply healing results, though it achieves a better tensional levels control, using less drugs and diminishing aldosterone levels. It implies a descent in myocardic and vascular toxicity.
METHODOLOGY: a retrospective study was carried out, checking out all HA1 masculine diagnosed patients of clinical records from 1981-2005.
RESULTS: 35 patients were diagnosed, with an average age of 50 and a predominance of men (82%). The main reason for starting the HA1 masculine study was persistent hypertension; other reasons were hypertension and hypopotassemia (34%). Sixteen of the cases were adenomas (7 classic adenomas and 9 renin-dependents) and fourteen of them were hyperplasia (10 bilateral hyperplasias and 4 primary adrenals hyperplasia). Five cases were excluded because they were waiting for complementary tests. For location diagnosis, gammagrafía I131cholesterol was the test showing more agreement with final diagnosis, and then RMN and TAC. In eight of the cases, an adrenal vein sampling was made. Ten of sixteen adenomas suffered a surgery performance. The result showed standardization of tensional levels, without any treatment in 60% of the cases. The rest of them are currently treated with spironolactone under an appropriate tensional control. Gynecomastia was the most usual adverse effect found.
CONCLUSION: Contrary to other published papers, we found out a male predominance in our database. A similar incidence of adenomas e hyperplasias was obtained. The most usual way of appearance was persistent hypertension to treatment. Adenomas surgery does not imply healing results, though it achieves a better tensional levels control, using less drugs and diminishing aldosterone levels. It implies a descent in myocardic and vascular toxicity.