Observational studyThe Journal of clinical endocrinology and metabolism2020
Patients With Primary Aldosteronism Respond to Unilateral Adrenalectomy With Long-Term Reduction in Salt Intake.
Observational study in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Meta-analysis of blood parameters related to lipid and glucose metabolism between two subtypes of primary aldosteronism.Journal of clinical hypertension (Greenwich, Conn.) · 2023Pooled it
- Sex-dependent modulation of T and NK cells and gut microbiome by low sodium diet in patients with primary aldosteronism.Frontiers in immunology · 2024Trial
- Effects of a low-sodium diet in patients with idiopathic hyperaldosteronism: a randomized controlled trial.Frontiers in endocrinology · 2023Trial
- Aldosterone-induced salt appetite requires HSD2 neurons.JCI insight · 2024Article
- Control of sodium appetite by hindbrain aldosterone-sensitive neurons.Molecular and cellular endocrinology · 2024Review
- Biomarkers to Guide Medical Therapy in Primary Aldosteronism.Endocrine reviews · 2024Review
- Low sodium intake ameliorates hypertension and left ventricular hypertrophy in mice with primary aldosteronism.Frontiers in physiology · 2023Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextHigh dietary salt intake is known to aggravate arterial hypertension. This effect could be of particular relevance in the setting of primary aldosteronism (PA), which is associated with cardiovascular damage independent of blood pressure levels. The aim of this study was to determine the impact of therapy on salt intake in PA patients. PATIENTS AND
methodsA total of 148 consecutive PA patients (66 with unilateral and 82 with bilateral PA) from the database of the German Conn's Registry were included. Salt intake was quantified by 24-hour urinary sodium excretion before and after initiation of PA treatment. STUDY
designObservational longitudinal cohort study.
settingTertiary care hospital.
resultsAt baseline, unilateral PA patients had a significantly higher urinary sodium excretion than patients with bilateral disease (205 vs 178 mmol/d, P = 0.047). Higher urinary sodium excretion correlated with an increased cardiovascular risk profile including proteinuria, impaired lipid, and glucose metabolism and was associated with higher daily doses of antihypertensive drugs to achieve blood pressure control. In unilateral disease, urinary sodium excretion dropped spontaneously to 176 mmol/d (P = 0.012) 1 year after unilateral adrenalectomy and remained low at 3 years of follow-up (174 mmol/d). In contrast, treatment with mineralocorticoid receptor antagonists (MRA) in bilateral PA patients was not associated with a significant change in urinary sodium excretion at follow-up (179 mmol/d vs 183 mmol/d).
conclusionPA patients consuming a high-salt diet, estimated based on urinary sodium excretion, respond to adrenalectomy with a significant reduction of salt intake, in contrast to MRA treatment.
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