Evidence map›Paper›PMID 33767283›Full record

Observational studyScientific reports2021

Age-stratified comparison of clinical outcomes between medical and surgical treatments in patients with unilateral primary aldosteronism.

Ryo Nakamaru, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Isao Kurihara, Takashi Yoneda, Takamasa Ichijo, Takuyuki Katabami, Mika Tsuiki, Norio Wada and 13 more

Open access · goldAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 20 institutions in 1 country.

Ryo NakamaruDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, 5650871, Japan.
Koichi YamamotoDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, 5650871, Japan. kyamamoto@geriat.med.osaka-u.ac.jp.
Hiroshi AkasakaDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, 5650871, Japan.
Hiromi RakugiDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, 5650871, Japan.
Isao KuriharaDepartment of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, Tokyo, Japan.
Takashi YonedaDepartment of Health Promotion and Medicine of the Future, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Takamasa IchijoDepartment of Diabetes and Endocrinology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
Takuyuki KatabamiDivision of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan.
Mika TsuikiDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Norio WadaDepartment of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan.
Tetsuya YamadaDepartment of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Hiroki KobayashiDivision of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, Tokyo, Japan.
Kouichi TamuraDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yoshihiro OgawaDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Junji KawashimaDepartment of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Nobuya InagakiDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Megumi FujitaDivision of Nephrology and Endocrinology, University of Tokyo, Tokyo, Japan.
Minemori WatanabeDepartment of Endocrinology and Diabetes, Okazaki City Hospital, Okazaki, Japan.
Kohei KamemuraDepartment of Cardiology, Shinko Hospital, Kobe, Japan.
Shintaro OkamuraDepartment of Endocrinology, Tenri Hospital, Tenri, Japan.
Akiyo TanabeDepartment of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan.
Mitsuhide NaruseDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
JPAS/JRAS Study Group
Kyoto University · JPThe University of Osaka · JPTokyo Medical and Dental University · JPKyoto Medical Center · JPSt. Marianna University School of Medicine · JPFukuoka University · JPGunma University · JPHiroshima General Hospital · JPHiroshima University · JPKeio University · JPMiwa Hospital · JPSanden (Japan) · JPGifu University · JPKanazawa University · JPKumamoto University · JPKyoto Prefectural University of Medicine · JPKyushu University · JPMatsuyama Red Cross Hospital · JPMie University · JPMito Saiseikai General Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although adrenalectomy (ADX) is an established treatment for unilateral primary aldosteronism (uPA), the influence of age on the surgical outcomes is poorly understood. Therefore, we aimed to elucidate how age affects the clinical outcomes after treatments. We analyzed 153 older (≥ 65 years) and 702 younger patients (< 65 years) with uPA, treated either with ADX or mineralocorticoid receptor antagonist (MRA) in the Japan PA Study, and compared the estimated glomerular filtration rate (eGFR) or blood pressure over a 36-month period after treatments. ADX-treated patients showed severer biochemical indicators than MRA-treated patients. During 6 and 36 months, the eGFR decreased more prominently in older but not in younger patients with ADX than in those with MRA, which remained significant after adjustment with the inverse probability of treatment weighting (IPTW). There was a significant interaction between the age-groups and the treatment choices in the change of the eGFR with IPTW-adjusted analysis. The post-treatment dose of antihypertensive medication was lower in younger and higher in older patients with ADX than those with MRA. The clinical benefit of ADX differed between younger and older patients with uPA. These findings indicate the need for further validation on whether ADX can benefit older patients with uPA.

Indexed as

AdrenalectomyAdultAgedAge FactorsBlood PressureFemaleGlomerular Filtration RateHumansHyperaldosteronismMaleMiddle AgedMineralocorticoid Receptor AntagonistsRetrospective StudiesTreatment OutcomeMineralocorticoid Receptor Antagonists

Identifiers

PMID33767283
PMCPMC7994572
OpenAlexW3112009202

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.