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HERO ID
6820893
Reference Type
Journal Article
Title
Renal damage in primary aldosteronism: results of the PAPY Study
Author(s)
Rossi, GP; Bernini, G; Desideri, G; Fabris, B; Ferri, C; Giacchetti, G; Letizia, C; Maccario, M; Mannelli, M; Matterello, MJ; Montemurro, D; Palumbo, G; Rizzoni, D; Rossi, E; Pessina, AC; Mantero, F; PAPY Study Participants
Year
2006
Is Peer Reviewed?
Yes
Journal
Hypertension
ISSN:
0194-911X
EISSN:
1524-4563
Volume
48
Issue
2
Page Numbers
232-238
Language
English
PMID
16801482
DOI
10.1161/01.HYP.0000230444.01215.6a
Web of Science Id
WOS:000239427900015
Abstract
Primary aldosteronism (PA) has been associated with cardiovascular hypertrophy and fibrosis, in part independent of the blood pressure level, but deleterious effects on the kidneys are less clear. Likewise, it remains unknown if the kidney can be diversely involved in PA caused by aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Hence, in the Primary Aldosteronism Prevalence in Italy (PAPY) Study, a prospective survey of newly diagnosed consecutive patients referred to hypertension centers nationwide, we sought signs of renal damage in patients with PA and in comparable patients with primary hypertension (PH). Patients (n = 1180) underwent a predefined screening protocol followed by tests for confirming PA and identifying the underlying adrenocortical pathology. Renal damage was assessed by 24-hour urine albumin excretion (UAE) rate and glomerular filtration rate (GFR). UAE rate was measured in 490 patients; all had a normal GFR. Of them, 31 (6.4%) had APA, 33 (6.7%) had IHA, and the rest (86.9%) had PH. UAE rate was predicted (P < 0.001) by body mass index, age, urinary Na+ excretion, serum K+, and mean blood pressure. Covariate-adjusted UAE rate was significantly higher in APA and IHA than in PH patients; there were more patients with microalbuminuria in the APA and IHA than in the PH group (P = 0.007). Among the hypertensive patients with a preserved GFR, those with APA or IHA have a higher UAE rate than comparable PH patients. Thus, hypertension because of excess autonomous aldosterone secretion features an early and more prominent renal damage than PH.
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