scholarly journals Characteristics and Outcomes in Primary Aldosteronism Patients Harboring Glucocorticoid-Remediable Aldosteronism

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1816
Author(s):  
Chung-Yi Cheng ◽  
Hung-Wei Liao ◽  
Kang-Yung Peng ◽  
Tso-Hsiao Chen ◽  
Yen-Hung Lin ◽  
...  
Keyword(s):  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Clinical Characteristics ◽  
Plasma Aldosterone ◽  
Clinical Factors ◽  
Clinical Predictors ◽  
Lower Plasma ◽  
Using Data ◽  
Low Serum

The clinical characteristics and surgical prognosis of glucocorticoid-remediable aldosteronism (GRA, also known as familial hyperaldosteronism type 1, FH-I) have not been widely studied. Using data from the Taiwan Primary Aldosteronism Investigation (TAIPAI) registry retrospectively, we describe the associated clinical factors for GRA and clinical predictors of surgical outcomes among identified GRA patients. We found 79 GRA-positive (51.2 ± 13.8 years; women 39 (49.4%)) and 114 GRA-negative primary aldosteronism (PA) patients matched with age, gender, and body mass index. Lower plasma aldosterone concentrations (PACs) and aldosterone-renin ratios were found among GRA-positive individuals. Multivariable logistic regression demonstrated that a PAC ≤ 40 ng/dL could predict concealed GRA individuals (OR 0.523, p = 0.037). Low serum potassium (OR 0.285, p = 0.008), but not the presence of GRA, was associated with hypertension-remission. Of note, PRA (OR 11.645, p = 0.045) and hypokalemia (OR 0.133, p = 0.048) were associated with hypertension-remission in GRA patients. Unilateral primary aldosteronism patients harboring concomitant GRA were not associated with inferior hypertension-remission after an adrenalectomy. Low serum potassium and high PRA were positively associated with hypertension-remission in GRA patients.

scholarly journals Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hidetada Fukuoka ◽  
Koichi Tachibana ◽  
Yukinori Shinoda ◽  
Tomoko Minamisaka ◽  
Hirooki Inui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Serum Potassium Level ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Factors ◽  
Low Serum

Abstract Backgrounds Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan. Methods We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results Systolic (p = 0.045) and diastolic (p = 0.004) blood pressure, serum sodium level (p = 0.002), and negative water balance (p = 0.036) were significantly higher and serum potassium level (p = 0.026) was significantly lower on admission day in patients with hypernatremia (n = 22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p = 0.034). Among patients with serum potassium level ≤ 3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p = 0.004). Conclusion In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8 mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.

scholarly journals Tolvaptan-Induced Hypernatremia Related to Low Serum Potassium Level Accompanying High Blood Pressure in Patients with Acute Decompensated Heart Failure

2020 ◽  
Author(s):  
Hidetada Fukuoka ◽  
Koichi Yachibana ◽  
Yukinori Shinoda ◽  
Tomoko Minamisaka ◽  
Hirooki Inui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Serum Potassium Level ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Factors ◽  
Low Serum

Abstract Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.

scholarly journals Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure.

2020 ◽  
Author(s):  
Hidetada Fukuoka ◽  
Koichi Yachibana ◽  
Yukinori Shinoda ◽  
Tomoko Minamisaka ◽  
Hirooki Inui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Serum Potassium Level ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Factors ◽  
Low Serum

Abstract Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.

scholarly journals Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure.

2020 ◽  
Author(s):  
Hidetada Fukuoka ◽  
Koichi Yachibana ◽  
Yukinori Shinoda ◽  
Tomoko Minamisaka ◽  
Hirooki Inui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Serum Potassium Level ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Factors ◽  
Low Serum

Abstract Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.

scholarly journals Urinary sodium potassium ratio is associated with clinical success after adrenalectomy in patients with unilateral primary aldosteronism

2021 ◽  
Vol 12 ◽  
pp. 204062232199027
Author(s):  
Ming-Jse Lee ◽  
Chiao-Yin Sun ◽  
Ching-Chu Lu ◽  
Yuan-Shian Chang ◽  
Heng-Chih Pan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Clinical Success ◽  
Plasma Aldosterone ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Sodium Potassium ◽  
Inflammatory Status ◽  
Lower Urinary

Background: The urinary sodium potassium (NaK) ratio is associated with dietary sodium and potassium intake and blood pressure, and it also reflects the activity of aldosterone. Herein we evaluated the value of the urinary NaK ratio in predicting the surgical outcomes of patients with unilateral primary aldosteronism (uPA). Methods: This non-concurrent prospective cohort study was conducted from 2011 to 2017 and included 241 uPA patients who had undergone adrenalectomy. Predictors of successful clinical outcomes were analyzed using logistic regression. Results: Among the 241 uPA patients, 197 (81.7%) achieved clinical complete or partial success. A urinary sodium potassium ratio <3 (odds ratio (OR): 2.5; 95% confidence interval (CI): 1.2–5.4; p = 0.015), body mass index <25 kg/m2 (OR: 2.82; 95% CI: 1.31–6.06; p = 0.008), renin <1 ng/mL/h (OR: 2.51; 95% CI: 1.01–6.21; p = 0.047) and mean preoperative blood pressure >115 mmHg (OR: 5.02; 95% CI: 2.10–11.97; p < 0.001) could predict clinical success after adrenalectomy. Furthermore, higher pre-treatment plasma aldosterone (OR: 1.014; 95% CI 1.005–1.024; p = 0.002) or lower serum potassium (OR: 0.523; 95% CI: 0.328–0.836; p = 0.007) were correlated with lower urinary NaK ratio (<3), and log urinary NaK ratio was positively correlated with serum C-reactive protein ( β value 2.326; 95% CI 0.029–4.623; p = 0.047). Conclusions: uPA patients with a lower urinary NaK ratio, due to high plasma aldosterone and low serum potassium concentrations, were more likely to have clinical success after adrenalectomy. uPA patients with a higher urinary NaK ratio were associated with more severe inflammatory status, and possibly more resistant hypertension post-operatively.

scholarly journals Tolvaptan-induced hypernatremia related to low serum potassium level accompanying high blood pressure in patients with acute decompensated heart failure

2020 ◽  
Author(s):  
Hidetada Fukuoka ◽  
Koichi Yachibana ◽  
Yukinori Shinoda ◽  
Tomoko Minamisaka ◽  
Hirooki Inui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Potassium Level ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Serum Potassium Level ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Clinical Factors ◽  
Low Serum

Abstract Backgrounds: Tolvaptan significantly increases urine volume in acute decompensated heart failure (ADHF); serum sodium level increases due to aquaresis in almost all cases. We aimed to elucidate clinical factors associated with hypernatremia in ADHF patients treated with tolvaptan.Methods: We enrolled 117 ADHF patients treated with tolvaptan in addition to standard therapy. We examined differences in clinical factors at baseline between patients with and without hypernatremia in the initial three days of hospitalization. Results: Systolic (p=0.045) and diastolic (p=0.004) blood pressure, serum sodium level (p=0.002), and negative water balance (p=0.036) were significantly higher and serum potassium level (p=0.026) was significantly lower on admission day in patients with hypernatremia (n=22). In multivariate regression analysis, hypernatremia was associated with low serum potassium level (p=0.034). Among patients with serum potassium level ≤3.8 mEq/L, the cutoff value obtained using receiver operating characteristic curve analysis, those with hypernatremia related to tolvaptan treatment showed significantly higher diastolic blood pressure on admission day (p=0.004).Conclusion: In tolvaptan treatment combined with standard therapy in ADHF patients, serum potassium level ≤ 3.8mEq/L may be a determinant factor for hypernatremia development. Among hypokalemic patients, those with higher diastolic blood pressure on admission may be carefully managed to prevent hypernatremia.

Prevalence and incidence of peripheral polyneuroapathy and correlation among different clinical factors in people with type 1 diabetes

2016 ◽  
Vol 11 (S 01) ◽  
Author(s):  
B Valiyeva ◽  
N Müller ◽  
G Eidner ◽  
C Kloos ◽  
G Wolf ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Factors

The clinical characteristics of primary hyperparathyroidism (PHPT) in patients with multiple endocrine neoplasia (MEN) type 1

2013 ◽  
Author(s):  
Liliya Rostomyan ◽  
Nataliya Mokrysheva ◽  
Anatoly Tiulpakov ◽  
Alla Artemova ◽  
Nataliya Kirdyankina ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Characteristics ◽  
Multiple Endocrine Neoplasia ◽  
Endocrine Neoplasia

Biochemical and clinical characteristics of polysystic ovarian syndrome (PCOS) in women with and without type 1 diabetes (TID)

2017 ◽  
Author(s):  
Anjuli Gunness ◽  
Agnieska Pazderska ◽  
Mohamed Ahmed ◽  
Niamh Phelan ◽  
Gerard Boran ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Characteristics ◽  
Ovarian Syndrome
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