Unmasked chronic renal function deterioration after unilateral adrenalectomy in patients with primary aldosteronism.

Abstract

We report 2 cases of chronic estimated glomerular filtration rate (eGFR) decline after unilateral adrenalectomy due to primary aldosteronism. The patients were diagnosed with unilateral adrenal cortical adenoma releasing aldosterone. Two patients were examined for hypertension and hypokalemia. Unilateral laparoscopic adrenalectomy was performed in both cases, and pathology confirmed adrenal cortical adenoma. After adrenalectomy, hypertension and hypokalemia improved to within normal range. However, the eGFR decreased postoperatively, and abdominal computed tomography scan showed decreased kidney size compared to previous images. Kidney biopsy was performed to delineate the exact cause of renal function deterioration and revealed hypertensive changes with chronic interstitial changes, indicating that glomerular hyperfiltration with aldosterone excess masked renal function damage. Physicians have to consider the probability of postadrenalectomy eGFR decline related to chronic hypertensive change.

• Authors: Su Min Park, Woo Jin Jung, Jong Man Park, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Nari Shin, Sang Heon Song
• Journal: Kidney research and clinical practice (Kidney Res Clin Pract) Vol. 35 Issue 4 Pg. 255-258 (Dec 2016) ISSN: 2211-9132 [Print] Korea (South)
• PMID: 27957422 (Publication Type: Journal Article)