PRIMARY ALDOSTERONISM: THE RESULTS OF THE TREATMENT ACCORDING TO THE DATA OF RENAL ARTERIES DUPLEX SCANNING
Abstract
In the structure of arterial hypertension, primary aldosteronism (РА) ranges from 5 to 15%. Changes in intrarenal hemodynamics are due to both high blood pressure and direct aldosterone level. The purpose of the study was to analyze the results of PA treatment according to ultrasound doppler scanning of renal arteries. In general, 55 patients with PA were treated. Renal arteries duplex scanning before and after the treatment was performed in 20 patients. During treatment, the normalization of Vps, Ved, S/D, PI, PI, AT, TAMX indices was recorded in patients. The RI of the interlobar arteries slightly increased, however, it remained within the reference range. The reduction of aldosterone levels led to increase of TAMX index at the level of the renal artery trunk, S/D, RI and decrease in AT at the level of the segmental arteries, as well as increase of Ved and S/D at the level of the interlobar arteries.
References
Williams TA, Lenders JWM, Mulatero P, et al. Primary Aldosteronism Surgery Outcome (PASO) investigators. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 2017 Sep;5(9):689-699. doi: 10.1016/S2213-8587(17)30135-3.
Monticone S, Burrello J, Tizzani D, et al. Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practice. J Am CollCardiol.2017 Apr 11;69(14):1811-1820. doi: 10.1016/j.jacc.2017.01.052.
Rekovets OL, Torbas OO, Kushnir SM et al. Struktura patsiientiv iz rezystentnoiu arterialnoiu hipertenziieiu [Structure of patients with resistant arterial hypertension]. Аrteryalnaia hypertenzyia, 2018; 1 (57), 46 – 66. [inUkrainian]. doi:10.22141/2224-1485.1.57.2018.125498.
Prejbisz A, Warchoł-Celińska E, Lenders JW, Januszewicz A. Cardiovascular Risk in Primary Hyperaldosteronism. HormMetab Res. 2015 Dec;47(13):973-80. doi: 10.1055/s-0035-1565124.Epub 2015 Nov 17.
Widimsky J Jr, Strauch B, Petrák O, et al. Vascular disturbances in primary aldosteronism: clinical evidence. Kidney BloodPress Res. 2012;35(6):529-33. doi: 10.1159/000340031. Epub 2012 Aug 8.
Varano M, Iacono P, Tedeschi MM, et al. Comparisons of microvascular and macrovascular changes in aldosteronism-related hypertension and essential hypertension. Sci Rep. 2017;7(1):2666. Published 2017 Jun 1. doi:10.1038/s41598-017-02622-2.
Prejbisz A, Warchoł-Celińska E, Lenders JW, et al. Cardiovascular Risk in Primary Hyperaldosteronism. Horm Metab Res. 2015 Dec;47(13):973-80.
Rizzoni D, Paiardi S, Rodella L, et al. Changes in extracellular matrix in subcutaneous small resistance arteries of patients with primary aldosteronism. J Clin Endocrinol Metab 2006; 91: 2638–2642.
Gosk-Przybylek M, Harazny J, Binczyk E, et al. Retinal Arteriolar Structure in Patients with Primary Aldosteronism. J Hypertens 2015; 33 (Suppl 1): e103.
Muiesan ML, Rizzoni D, Salvetti M, et al. Structural changes in small resistance arteries and left ventricular geometry in patients with primary and secondary hypertension. J Hypertens 2002; 20: 1439–1444.
Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab [Internet]. 2016;101(5):1889–916.
Iwakura Y, Ito S, Morimoto R, Kudo M, Ono Y, Nezu M, Takase K, Seiji K,Ishidoya S, Arai Y, Funamizu Y, Miki T, Nakamura Y, Sasano H, Satoh F. Renal Resistive Index Predicts Postoperative Blood Pressure Outcome in Primary Aldosteronism. Hypertension.2016 Mar;67(3):654-60. doi:10.1161/HYPERTENSIONAHA.115.05924. Epub 2016 Jan 25.
Muiesan ML, Rizzoni D, Salvetti M, et al. Structural changes in small resistance arteries and left ventricular geometry in patients with primary and secondary hypertension. J Hypertens 2002; 20: 1439–1444.
Wu VC, Kuo CC, Wang SM, et al. Primary aldosteronism: Changes in cystatin C-based kidney filtration, proteinuria, and renal duplex indices with treatment. J Hypertens. 2011;29(9):1778–86.
Views:
151
Downloads:
159
Copyright (c) 2019 The author
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.