Kidney function in patients with adrenal adenomas : A single-center retrospective cohort study
© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
OBJECTIVE: Patients with nonfunctioning adrenal adenomas (NFA) and mild autonomous cortisol secretion (MACS) demonstrate an increased risk of chronic kidney disease (CKD), however factors associated with CKD are unknown. We aimed to identify the factors associated with CKD and assess the impact of adrenalectomy on kidney function in patients with NFA or MACS.
DESIGN: Single-center cohort study of patients with NFA and MACS, 1999-2020.
METHODS: MACS was diagnosed based on post-dexamethasone cortisol (DST) ≥ 1.8 mcg/dL. Age, sex, dysglycemia, hypertension, therapy with statin, angiotensin converting enzyme inhibitor, or angiotensin II receptor blocker were included in the multivariable analysis. Outcomes included estimated glomerular filtration rate (eGFR) at the time of diagnosis with MACS or NFA and post-adrenalectomy delta eGFR.
RESULTS: Of 972 patients, 429 (44%) had MACS and 543 (56%) had NFA. At the time of diagnosis, patients with MACS had lower eGFR (median 79.6 vs 83.8 ml/min/1.73m2, p < 0.001) than patients with NFA. In a multivariable analysis, factors associated with lower eGFR were older age, hypertension, and higher DST. In 204 patients (MACS: 155, 76% and NFA: 49, 24%) treated with adrenalectomy, post adrenalectomy eGFR improved in both groups starting at 18 months up to 3.5 years of follow up. Factors associated with increased eGFR were younger age, lower pre-adrenalectomy eGFR and longer follow-up period.
CONCLUSION: DST cortisol is an independent risk factor for lower eGFR in patients with adrenal adenomas. Both patients with MACS and NFA demonstrate an increase in eGFR post-adrenalectomy, especially younger patients with lower eGFR pre-adrenalectomy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
The Journal of clinical endocrinology and metabolism - (2023) vom: 29. Dez. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Rahimi, Leili [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Chronic kidney disease |
|---|
| Anmerkungen: |
Date Revised 29.12.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1210/clinem/dgad765 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366480553 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366480553 | ||
| 003 | DE-627 | ||
| 005 | 20240108140932.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1210/clinem/dgad765 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1246.xml |
| 035 | |a (DE-627)NLM366480553 | ||
| 035 | |a (NLM)38157409 | ||
| 035 | |a (PII)dgad765 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Rahimi, Leili |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Kidney function in patients with adrenal adenomas |b A single-center retrospective cohort study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 29.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVE: Patients with nonfunctioning adrenal adenomas (NFA) and mild autonomous cortisol secretion (MACS) demonstrate an increased risk of chronic kidney disease (CKD), however factors associated with CKD are unknown. We aimed to identify the factors associated with CKD and assess the impact of adrenalectomy on kidney function in patients with NFA or MACS | ||
| 520 | |a DESIGN: Single-center cohort study of patients with NFA and MACS, 1999-2020 | ||
| 520 | |a METHODS: MACS was diagnosed based on post-dexamethasone cortisol (DST) ≥ 1.8 mcg/dL. Age, sex, dysglycemia, hypertension, therapy with statin, angiotensin converting enzyme inhibitor, or angiotensin II receptor blocker were included in the multivariable analysis. Outcomes included estimated glomerular filtration rate (eGFR) at the time of diagnosis with MACS or NFA and post-adrenalectomy delta eGFR | ||
| 520 | |a RESULTS: Of 972 patients, 429 (44%) had MACS and 543 (56%) had NFA. At the time of diagnosis, patients with MACS had lower eGFR (median 79.6 vs 83.8 ml/min/1.73m2, p < 0.001) than patients with NFA. In a multivariable analysis, factors associated with lower eGFR were older age, hypertension, and higher DST. In 204 patients (MACS: 155, 76% and NFA: 49, 24%) treated with adrenalectomy, post adrenalectomy eGFR improved in both groups starting at 18 months up to 3.5 years of follow up. Factors associated with increased eGFR were younger age, lower pre-adrenalectomy eGFR and longer follow-up period | ||
| 520 | |a CONCLUSION: DST cortisol is an independent risk factor for lower eGFR in patients with adrenal adenomas. Both patients with MACS and NFA demonstrate an increase in eGFR post-adrenalectomy, especially younger patients with lower eGFR pre-adrenalectomy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a MACS | |
| 650 | 4 | |a chronic kidney disease | |
| 650 | 4 | |a glomerular filtration rate | |
| 650 | 4 | |a mild autonomous cortisol secretion | |
| 650 | 4 | |a outcome | |
| 700 | 1 | |a Kittithaworn, Annop |e verfasserin |4 aut | |
| 700 | 1 | |a Gregg Garcia, Raul |e verfasserin |4 aut | |
| 700 | 1 | |a Saini, Jasmine |e verfasserin |4 aut | |
| 700 | 1 | |a Dogra, Prerna |e verfasserin |4 aut | |
| 700 | 1 | |a Atkinson, Elizabeth J |e verfasserin |4 aut | |
| 700 | 1 | |a Achenbach, Sara J |e verfasserin |4 aut | |
| 700 | 1 | |a Kattah, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Bancos, Irina |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of clinical endocrinology and metabolism |d 1945 |g (2023) vom: 29. Dez. |w (DE-627)NLM00001821X |x 1945-7197 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:29 |g month:12 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1210/clinem/dgad765 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 29 |c 12 | ||