ECE2022 Rapid Communications Rapid Communications 14: Late Breaking (8 abstracts)
1Rigshospitalet, Department of Endocrinology and Metabolism, Copenhagen, Denmark; 2Herlev Hospital, Herlev, Denmark; 3Rigshospitalet, Department of Radiology, Copenhagen, Denmark
Adrenalectomy for primary aldosteronism has been associated with post-surgical kidney failure. It has been proposed that elimination of excess aldosterone demask an underlying failure of the kidney function. Contralateral suppression (CLS) is considered an indication of aldosterone excess and disease severity and the purpose of this study was to assess the hypothesis that CLS would predict change in kidney function after adrenalectomy in patients with primary aldosteronism. We included patients diagnosed with primary aldosteronism referred for adrenal venous between May 2011 and August 2021 and who were subsequently offered surgical or medical treatment. A total of 138 patients were included and after adrenal venous sampling 85/138 (61.6%) underwent adrenalectomy while 53/138 (38.4%) were treated with MR-antagonists. Among surgically treated patients, 59/85 (69.4%) were classified as having CLS. In this patient group, eGFR was reduced by 17.5 (SD 17.6) ml/min/1.73 m2 compared to an increase of 1.8 (SD 12.8) mL/min/1.73 m2 in patients without CLS (P<0.001). The association between contralateral suppression and the change in kidney function remained unchanged in multivariate analysis. Post-surgery, 16/59 (27.1%) patients with CLS developed hyperkaliemia compared to 2/26 (7.7%) in patients without CLS (P=0.04).This retrospective study found that CLS is a strong and independent predictor of a marked reduction of eGFR and an increased risk of hyperkalemia after adrenalectomy in patients with primary aldosteronism.