Photo Credit: Md Babul Hosen

The following is a summary of “A comparative study of postadrenalectomy hyperuricemia and renal impairment in patients with unilateral primary aldosteronism: does histopathology subtype matter?” published in the October 2024 issue of Nephrology by Fang et al. 

Primary aldosteronism (PA) affects 5–18% of patients with hypertension and is a major cause of secondary hypertension. This cohort study examines the impact of adrenalectomy on serum uric acid (SUA) levels and renal filtration in patients with unilateral primary aldosteronism (uPA), focusing on histopathological subtypes and vessel stiffness 1-year post-surgery. 

Researchers conducted a retrospective study to evaluate the correlation between post-adrenalectomy SUA levels and estimated glomerular filtration rate (eGFR) with pathologic features and assess their impact on peripheral vessel stiffness and brachial-ankle pulse wave velocity (baPWV) at 1-year post-surgery. 

They included 100 patients diagnosed with uPA who underwent adrenalectomy between Jan. 1, 2007, and Dec. 31, 2022. 

The results showed elevated SUA levels, hyperuricemia, and a >25% decrease in eGFR were significantly more common in the classical group than the nonclassical group. Overall, postoperative hyperuricemia, referred to as post-adrenalectomy hyperuricemia (PAHU), occurred in 29% (29/100) of patients, with rates of 34.8% (23/66) in the classical group and 17.6% (6/34) in the nonclassical group. The incidence of a greater than 25% reduction in eGFR was 33% (33/100), with 43.9% (29/66) in the classical group and 11.8% (4/34) in the nonclassical group. Additionally, baPWV decreased more in the classical group. 

Investigators concluded that monitoring serum uric acid levels, urine pH, and conducting imaging studies were recommended for patients with PAHU and renal impairment, particularly among males with classical histopathology. These assessments aimed to determine the need for drug intervention in asymptomatic cases. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03750-4#Abs1