Prognosis of primary aldosteronism in Japan: results from a nationwide epidemiological study

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Author(s)

    • Miyake Yoshihiro
    • Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
    • Satoh Fumitoshi
    • Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
    • Yamada Masanobu
    • Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
    • Ueshiba Hajime
    • Department of Internal Medicine, Toho University School of Medicine, Tokyo 143-0015, Japan
    • Katabami Takuyuki
    • Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama 241-0811, Japan
    • Tanaka Hirotoshi
    • Department of Rheumatology and Allergy, Institute of Medical Science, The University of Tokyo, Tokyo 108-8039, Japan
    • Tanahashi Yusuke
    • Department of Pediatrics, Asahikawa Medical University, Asahikawa 078-8510, Japan
    • Suzuki Shigeru
    • Department of Pediatrics, Asahikawa Medical University, Asahikawa 078-8510, Japan
    • Hasegawa Tomonobu
    • Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan
    • Katsumata Noriyuki
    • Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
    • Tanaka Keiko
    • Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
    • Tajima Toshihiro
    • Department of Pediatrics, Hokkaido University School of Medicine, Sapporo 060-8635, Japan
    • Yanase Toshihiko
    • Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
    • Nishikawa Tetsuo
    • Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama 222-0036, Japan
    • Naruse Mitsuhide
    • Department of Endocrinology, Metabolism and Hypertension, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
    • Takayanagi Ryoichi
    • Department of Medicine and Bioregulatory Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
    • Sasano Hironobu
    • Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
    • Takeda Yoshiyu
    • Division of Endocrinology and Hypertension, Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan
    • Shibata Hirotaka
    • Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yuhu 879-5593, Japan
    • Sone Masakatsu
    • Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan

Abstract

The Research Committee of Disorders of Adrenal Hormones, Japan, undertook a nationwide epidemiological study of primary aldosteronism (PA). The present study was undertaken as a part of this study to reveal the relationship between type of treatment and the prognosis of PA. In the primary survey, 4161 patients with PA during the period January 1, 2003-December 31, 2007 were reported from 3252 departments of internal medicine, pediatrics and urology. In the secondary survey, a questionnaire that requested detailed clinical information on individual patients was sent to those departments reporting patients in the primary survey. In total, data on 1706 patients with PA were available in the present study. Among patients with bilateral or unilateral aldosterone-producing adenoma, after adjustment for age at which prognosis was examined, sex, surgical treatment and medical treatment, surgical treatment was significantly associated with amelioration of hypertension (adjusted odds ratio [OR]: 0.47 [95% confidence interval (CI): 0.29–0.77]) and hypokalemia (adjusted OR: 0.17 [95% CI: 0.11–0.29]). No significant relationship was observed between medical treatment and such prognosis in this group of patients. Among patients with bilateral or unilateral adrenal hyperplasia, surgical, but not medical, treatment was significantly associated with amelioration of hypokalemia (adjusted OR: 0.23 [95% CI: 0.06–0.74]), while there was no relationship between surgical or medical treatment and the prognosis of hypertension. In conclusion, surgery offered a better prognosis of PA than medication with regards to hypertension and hypokalemia, with the limitation that a new anti-aldosterone drug, eplerenone, was not available during the study period.

Journal

  • Endocrine Journal

    Endocrine Journal 61(1), 35-40, 2014

    The Japan Endocrine Society

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