• J Formos Med Assoc · Jul 2020

    Preoperative non-stimulated adrenal venous sampling index for predicting outcomes of adrenalectomy for unilateral primary aldosteronism.

    • Chien-Wei Huang, Bo-Ching Lee, Kao-Lang Liu, Yeun-Chung Chang, Vin-Cent Wu, Po-Tsang Lee, Chin-Chen Chang, and TAIPAI Study Group.
    • Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, and National Yang-Ming University, School of Medicine, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    • J Formos Med Assoc. 2020 Jul 1; 119 (7): 1185-1192.

    Background/PurposeThe aim of this study was to predict outcomes of adrenalectomy for unilateral primary aldosteronism (PA) using non-stimulated adrenal venous sampling (AVS) indices and the standardized Primary Aldosteronism Surgical Outcome (PASO) criteria.MethodsPatients with unilateral PA who underwent adrenalectomy based on non-stimulated AVS and had follow-up data regarding surgical outcomes between 2011 and 2016 were enrolled. Demographic data and non-stimulated AVS indices, including lateralization index (LI) and contralateral suppression, were collected for analysis.ResultsThis study included 54 patients who underwent adrenalectomy. Clinical and biochemical outcomes were evaluated in all patients and in 52 (96.3%) patients, respectively. Complete clinical and biochemical success was achieved in 31 (57.4%) of 54 patients and 42 (80.8%) of 52 patients, respectively. An LI > 4 was significantly associated with complete clinical and biochemical success (OR = 4.30, 95% CI 1.18-15.68, p = 0.03, and OR = 7.55, 95% CI 1.28-44.47, p = 0.03, respectively). Contralateral suppression was an independent predictor of complete biochemical success (OR = 17.27, 95% CI 1.95-153.21, p = 0.01).ConclusionNon-stimulated AVS indices including LI and contralateral suppression are reliable preoperative determinants for predicting the outcomes of adrenalectomy in patients with unilateral PA. Our findings provide more evidence and confidence to clinicians when applying non-stimulated AVS to determine PA treatment.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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