Clinical Features of Patients with Primary Aldosteronism

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Abstract

Objective

To investigate the value of adrenal venous sampling (AVS) in the subtype classification and clinical features of primary aldosteronism (PA)

Methods

Three hundred and eight PA patients including 193 males and 115 females were recruited in this study. PA was diagnosed by aldosterone-renin ratio (ARR) screening, confirmation tests and AVS subtype classification. The patients were classified into two groups, 106 unilateral and 202 bilateral PA cases.

Results

The proportion of the unilateral and bilateral lesions was 34.4% and 65.6%, respectively. Compared with the bilateral group, the unilateral group has lower plasma renin activity (P<0.05) and higher ARR (P<0.05). The positive rates of adrenal computerized tomography in unilateral and bilateral lesions were 69.2% and 65.0%, respectively. The proportion of bilateral lesions in male patients were higher than in females (68.9% vs. 60.0%, P<0.01). The proportion of unilateral cases in the hypokalemic group was higher than in normal serum potassium group (39.6% vs. 31.6%, P=0.006). The proportion of bilateral lesions in obesity patients (BMI≥28 kg/m2) were higher than in non-obesity PA patients (71.8%% vs. 60.8%%, P<0.01).

Conclusion

The prevalence of bilateral lesion is more common while the clinical characteristics of unilateral lesion are more typical in PA patients. The proportion of bilateral lesion is more common in males and obesity PA patients while the unilateral lesion is more common in PA patients with hypokalemia.

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