The Adrenal Vein Sampling Outcomes Study (AVOS): success rates following adrenalectomy for unilateral primary aldosteronism

Sawyer, Nicola; Glendenning, Paul; Vasikaran, Samuel; Page, Michael M.; Schie, Greg van; Wong, Sze Ling; Yang, Jun; Schlaich, Markus; Bell, Damon A.

doi:10.1016/j.pathol.2023.02.002

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…Sawyer, et al. ( 35 ) conducted follow-up evaluations on 47 Australian PA patients who underwent unilateral adrenalectomy using the PASO criteria. The results showed that among the 40 patients who achieved clinical outcomes, 35.0% (14/40) had complete clinical success, and 47.5% (19/40) had partial clinical success.…”

Section: Assessment Of Surgical Outcomesmentioning

confidence: 99%

Adrenalectomy for primary aldosteronism and its related surgical characteristics

Xiang,

Zhang,

Song

et al. 2024

Front. Endocrinol.

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Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenalectomy is an effective treatment for unilateral PA, particularly aldosterone-producing adenoma (APA), resulting in improvements in biochemical parameters and blood pressure in the vast majority of patients. The article provides a comprehensive overview of PA, focusing on the outcomes of adrenalectomy for PA and the factors that may suggest prognostic implications. Analysis of the outcome of different PA patients undergoing adrenalectomy in terms of preoperative factors, vascular and adipose conditions, type of pathology, and somatic variants. In addition, it is recommended to use the histopathology of primary aldosteronism (HISTALDO) consensus to classify the patient’s pathological type, with classical and nonclassical pathological types showing a different prognosis and possibly being associated with an unresected contralateral adrenal gland. The primary aldosteronism surgical outcome (PASO) consensus sets uniform standards for postoperative outcomes in unilateral PA, but its setting of thresholds remains controversial. Partial adrenalectomy shows similar surgical results and fewer postoperative complications than total adrenalectomy, but there is a risk of missing the true source of abnormal aldosterone secretion. Steroid profiling and functional imaging techniques offer alternative options to adrenal vein sampling (AVS) for unilateral and bilateral judgments in patients with PA. A combination of factors is needed to predict the prognosis of PA patients undergoing adrenalectomy in order to manage patient expectations of the outcome of the procedure and to closely monitor blood pressure and biochemical parameters in patients who suggest a poorer prognosis.

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Section: Assessment Of Surgical Outcomesmentioning

confidence: 99%

Adrenalectomy for primary aldosteronism and its related surgical characteristics

Xiang,

Zhang,

Song

et al. 2024

Front. Endocrinol.

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Aldosterone and renin concentrations and blood pressure in young Indigenous and non‐Indigenous adults in the Northern Territory: a cross‐sectional study

Gwini

Stowasser

et al. 2023

Medical Journal of Australia

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ObjectivesTo evaluate aldosterone and renin levels and aldosterone‐to‐renin ratios (ARRs) in young Indigenous and non‐Indigenous adults in the Northern Territory, and their association with blood pressure levels.DesignCross‐sectional study; single time point sub‐study of two prospective birth cohort studies.Setting, participantsParticipants in the Aboriginal Birth Cohort (ABC) — born to Indigenous mothers at the Royal Darwin Hospital during 1987–1990 — and the Top End Cohort (TEC) — people born to non‐Indigenous mothers in Darwin, recruited during 2007–2009 — aged 32–35 years at the time of this sub‐study.Main outcome measuresPlasma aldosterone and direct renin concentrations; ARRs (positive screening test result for primary aldosteronism defined as > 70 pmol/mU); systolic and diastolic blood pressure.ResultsA total of 255 ABC (205 in remote, 50 in urban locations) and 76 TEC members participated. Median aldosterone concentration was similar for all three groups. The median renin concentration was 7.5 mU/L (interquartile range [IQR], 4.1–12.4 mU/L) in the TEC group, 12.4 mU/L (IQR, 5.1–19 mU/L) in the urban ABC group, and 29.3 mU/L (IQR, 15.0–52.9 mU/L) in the remote ABC group. The median ARR was 10 pmol/mU (IQR, 6–19 pmol/mU) in the remote ABC group, 28 pmol/mU (IQR, 16–70 pmol/mU) in the urban ABC group, and 43 pmol/mU (IQR, 26–74 pmol/mU) in the TEC group. Thirteen urban ABC participants (26%), 21 TEC participants (28%), and six people in the remote ABC group (3%) had ARR values above 70 pmol/mU. Adjusted for age and body mass index (BMI), mean systolic and diastolic blood pressure were lower for women than men in all participant groups; after adjusting for age, sex, and BMI, larger ARR was associated with higher systolic blood pressure in the TEC group but not the two ABC groups.ConclusionScreening test results for primary aldosteronism were positive for about one‐quarter of urban Indigenous and non‐Indigenous participants. A prospective study that includes confirmatory testing would more accurately assess the prevalence of primary aldosteronism among Indigenous Australians in the Northern Territory.

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The Adrenal Vein Sampling Outcomes Study (AVOS): success rates following adrenalectomy for unilateral primary aldosteronism

Cited by 2 publications

References 33 publications

Adrenalectomy for primary aldosteronism and its related surgical characteristics

Adrenalectomy for primary aldosteronism and its related surgical characteristics

Aldosterone and renin concentrations and blood pressure in young Indigenous and non‐Indigenous adults in the Northern Territory: a cross‐sectional study

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