The Journal of clinical endocrinology and metabolism · 2018
Significance of Computed Tomography and Serum Potassium in Predicting Subtype Diagnosis of Primary Aldosteronism.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Umakoshi Hironobu, Tsuiki Mika, Takeda Yoshiyu, Kurihara Isao, Itoh Hiroshi, Katabami Takuyuki, Ichijo Takamasa, Wada Norio, Yoshimoto Takanobu, Ogawa Yoshihiro, Kawashima Junji, Sone Masakatsu, Inagaki Nobuya, Takahashi Katsutoshi, Watanabe Minemori, Matsuda Yuichi, Kobayashi Hiroki, Shibata Hirotaka, Kamemura Kohei, Otsuki Michio, Fujii Yuichi, Yamamto Koichi, Ogo Atsushi, Yanase Toshihiko, Suzuki Tomoko, Naruse Mitsuhide, JPAS Study Group
Аннотация
CONTEXT: The number of centers with established adrenal venous sampling (AVS) programs for the subtype diagnosis of primary aldosteronism (PA) is limited.
OBJECTIVE: Aim was to develop an algorithm for AVS based on subtype prediction by computed tomography (CT) and serum potassium.
DESIGN: A multi-institutional retrospective cohort study in Japan.
PATIENTS: A total of 1591 patients with PA were classified into four groups according to CT findings and potassium status. Subtype diagnosis of PA was determined by AVS.
MAIN OUTCOME MEASURE: Prediction value of the combination of CT findings and potassium status for subtype diagnosis.
RESULTS: The percentages of unilateral hyperaldosteronism on AVS were higher in patients with unilateral disease on CT than those with bilateral normal results on CT (50.8% vs 14.6%, P < 0.01), and these percentages were higher in those with hypokalemia than those with normokalemia (58.4% vs 11.5%, P < 0.01). The prevalence and odds ratio for unilateral hyperaldosteronism on AVS were as follows: bilateral normal on CT with normokalemia, 6.2% (reference); unilateral disease on CT with normokalemia, 23.8% and 4.8 [95% confidence interval (CI), 3.1 to 7.2]; bilateral normal on CT with hypokalemia, 38.1% and 9.4 (95% CI, 6.2 to 14.1), and unilateral disease on CT with hypokalemia, 70.6% and 36.4 (95% CI, 24.7 to 53.5).
CONCLUSIONS: Patients with PA with bilateral normal results on CT and normokalemia likely have a low prior probability of a lateralized form of AVS and could be treated medically, whereas those with unilateral disease on CT and hypokalemia have a high probability of a lateralized form of AVS.
OBJECTIVE: Aim was to develop an algorithm for AVS based on subtype prediction by computed tomography (CT) and serum potassium.
DESIGN: A multi-institutional retrospective cohort study in Japan.
PATIENTS: A total of 1591 patients with PA were classified into four groups according to CT findings and potassium status. Subtype diagnosis of PA was determined by AVS.
MAIN OUTCOME MEASURE: Prediction value of the combination of CT findings and potassium status for subtype diagnosis.
RESULTS: The percentages of unilateral hyperaldosteronism on AVS were higher in patients with unilateral disease on CT than those with bilateral normal results on CT (50.8% vs 14.6%, P < 0.01), and these percentages were higher in those with hypokalemia than those with normokalemia (58.4% vs 11.5%, P < 0.01). The prevalence and odds ratio for unilateral hyperaldosteronism on AVS were as follows: bilateral normal on CT with normokalemia, 6.2% (reference); unilateral disease on CT with normokalemia, 23.8% and 4.8 [95% confidence interval (CI), 3.1 to 7.2]; bilateral normal on CT with hypokalemia, 38.1% and 9.4 (95% CI, 6.2 to 14.1), and unilateral disease on CT with hypokalemia, 70.6% and 36.4 (95% CI, 24.7 to 53.5).
CONCLUSIONS: Patients with PA with bilateral normal results on CT and normokalemia likely have a low prior probability of a lateralized form of AVS and could be treated medically, whereas those with unilateral disease on CT and hypokalemia have a high probability of a lateralized form of AVS.