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KMID : 1102220160350040255
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Kidney Research and Clinical Practice
2016 Volume.35 No. 4 p.255 ~ p.258
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Unmasked chronic renal function deterioration after unilateral adrenalectomy in patients with primary aldosteronism
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Park Su-Min
Jung Woo-Jin
Park Jong-Man
Rhee Ha-Rin
Kim Il-Young
Seong Eun-Young
Lee Dong-Won
Lee Soo-Bong
Kwak Ihm-Soo
Shin Na-Ri
Song Sang-Heon
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Abstract
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We report 2 cases of chronic estimated glomerular filtration rate (eGFR) decline after unilateral adrenalectomy due to primary aldosteronism. The patients were diagnosed with unilateral adrenal cortical adenoma releasing aldosterone. Two
patients were examined for hypertension and hypokalemia. Unilateral laparoscopic adrenalectomy was performed in both cases, and pathology confirmed adrenal cortical adenoma. After adrenalectomy, hypertension and hypokalemia improved to within normal range. However, the eGFR decreased postoperatively, and abdominal computed tomography scan showed decreased kidney size compared to previous images. Kidney biopsy was performed to delineate the exact cause of renal function deterioration and revealed hypertensive changes with chronic interstitial changes, indicating that glomerular hyperfiltration with aldosterone excess masked renal function damage. Physicians have to consider the probability of postadrenalectomy eGFR decline related to chronic hypertensive change.
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KEYWORD
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Adrenalectomy, Chronic kidney disease, Glomerular filtration rate, Primary aldosteronism
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