Renal Damage in Primary Aldosteronism: Results of the PAPY Study
Abstract
Primary aldosteronism (PA) has been associated with cardiovascular hypertrophy and fibrosis, in part independent of the blood pressure level, but deleterious effects on the kidneys are less clear. Likewise, it remains unknown if the kidney can be diversely involved in PA caused by aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Hence, in the Primary Aldosteronism Prevalence in Italy (PAPY) Study, a prospective survey of newly diagnosed consecutive patients referred to hypertension centers nationwide, we sought signs of renal damage in patients with PA and in comparable patients with primary hypertension (PH). Patients (n = 1180) underwent a predefined screening protocol followed by tests for confirming PA and identifying the underlying adrenocortical pathology. Renal damage was assessed by 24-hour urine albumin excretion (UAE) rate and glomerular filtration rate (GFR). UAE rate was measured in 490 patients; all had a normal GFR. Of them, 31 (6.4%) had APA, 33 (6.7%) had IHA, and the rest (86.9%) had PH. UAE rate was predicted (P < 0.001) by body mass index, age, urinary Na+ excretion, serum K+, and mean blood pressure. Covariate-adjusted UAE rate was significantly higher in APA and IHA than in PH patients; there were more patients with microalbuminuria in the APA and IHA than in the PH group (P = 0.007). Among the hypertensive patients with a preserved GFR, those with APA or IHA have a higher UAE rate than comparable PH patients. Thus, hypertension because of excess autonomous aldosterone secretion features an early and more prominent renal damage than PH.
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Diabetes/metabolic syndrome, renal damage, impaired bone mineral density, and osteoporosis have been reported more prevalent in AI patients with PA.
“Diabetes mellitus/metabolic syndrome (278,279), renal damage (280), impaired bone mineral density (81), and osteoporosis (264,281,282) have also been reported to be more prevalent in AI patients with PA.”
From Adrenal incidentaloma (2020) · cites this paper as [280]
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- Authors
- Rossi, G. P., Bernini, G., Desideri, G., Fabris, B., Ferri, C., Giacchetti, G., Letizia, C., Maccario, M., Mannelli, M., Matterello, M.-J., Montemurro, D., Palumbo, G., Rizzoni, D., Rossi, E., Pessina, A. C., & Mantero, F.
- Affiliations
- University of Padua (IT)
- ORCID
- Venue
- Hypertension
- Published
- 2006-08
- Volume
- 48
- Issue
- 2
- Pages
- 232-238
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2156939318
- Cited by
- 470
- References
- 53
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 13 · 2023: 13 · 2022: 30 · 2021: 30 · 2020: 26 · 2019: 30 · 2018: 24 · 2017: 21 · 2016: 18 · 2015: 31 · 2014: 25 · 2013: 19 · 2012: 31
- FWCI
- 16.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- primary aldosteronism, kidney injury, aldosterone-producing adenoma, idiopathic hyperaldosteronism, microalbuminuria, urinary albumin excretion, glomerular filtration rate, essential hypertension
- MeSH terms
- Albuminuria, Blood Pressure, Creatinine, Glomerular Filtration Rate, Humans, Hyperaldosteronism, Hypertension, Italy, Kidney Diseases, Kidney Function Tests, Middle Aged, Potassium, Predictive Value of Tests, Prospective Studies, Renin, Cohort Studies, Biomarkers, Comorbidity, Causality, Prevalence
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