Review
Endocrinology & Metabolism
Cheng-Hsuan Tsai, Ya-Li Chen, Chien-Ting Pan, Yen-Tin Lin, Po-Chin Lee, Yu-Wei Chiu, Che-Wei Liao, Zheng-Wei Chen, Chin-Chen Chang, Yi-Yao Chang, Chi-Sheng Hung, Yen-Hung Lin
Summary: The meta-analysis results showed that compared to PA patients receiving adrenalectomy and patients with essential hypertension, PA patients receiving MRA treatment had a higher risk of NOAF.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Medicine, General & Internal
Fabrizio Buffolo, Giovanni Cavaglia, Jacopo Burrello, Martina Amongero, Martina Tetti, Alessio Pecori, Elisa Sconfienza, Franco Veglio, Paolo Mulatero, Silvia Monticone
Summary: Previous studies have shown that patients with primary aldosteronism (PA) have impaired quality of life compared to the general population. However, a direct comparison with patients with essential hypertension (EH) has not been conducted before. This study found that both surgical and medical treatments can significantly improve the quality of life for PA patients, while EH patients only experience minimal improvement in some domains after optimization of blood pressure control.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2021)
Article
Multidisciplinary Sciences
Oskar Ragnarsson, Andreas Muth, Gudmundur Johannsson, Eleftheria Gkaniatsa, Eva Jakobsson Ung, Sofie Jakobsson
Summary: This study aimed to describe the most troublesome symptoms for patients with PA and explore health-related worries and expectations following treatment. The findings highlight the need for improving patient care by reducing diagnostic delay, providing comprehensive disease information, and implementing structured long-term follow-up for all patients with PA.
Article
Endocrinology & Metabolism
Yujiro Nakano, Masanori Murakami, Kazunari Hara, Tatsuya Fukuda, Masato Horino, Akira Takeuchi, Yoshihiro Niitsu, Kumiko Shiba, Kazutaka Tsujimoto, Chikara Komiya, Minato Yokoyama, Kenji Ikeda, Takanobu Yoshimoto, Yasuhisa Fujii, Tetsuya Yamada
Summary: This study explores the effects of adrenalectomy or mineralocorticoid receptor antagonist treatment on the long-term renal function of primary aldosteronism patients with chronic kidney disease (CKD). The results indicate that treatment is safe and useful in preventing renal injury in stage 3 CKD patients with primary aldosteronism.
CLINICAL ENDOCRINOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Tomomi Ueda, Yuya Tsurutani, Jun Osada, Kosuke Inoue, Yoshitomo Hoshino, Masato Ono, Kazuki Nakai, Jun Saito, Kazuhiko Yumoto, Tetsuo Nishikawa
Summary: This study found no significant difference in cardioprotective efficacy between surgical and medication treatment for primary aldosteronism under similar disease severity, although some patients with severe hyperaldosteronism underwent surgery.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Endocrinology & Metabolism
M. Araujo-Castro, M. Paja Fano, B. Pla Peris, M. Gonzalez Boillos, E. Pascual-Corrales, A. M. Garcia Cano, P. Parra Ramirez, P. Martin Rojas-Marcos, J. G. Ruiz-Sanchez, A. Vicente Delgado, E. Gomez Hoyos, R. Ferreira, I. Garcia Sanz, M. Recasens Sala, R. Barahona San Millan, M. J. Picon Cesar, P. Diaz Guardiola, C. M. Perdomo, L. Manjon Miguelez, R. Garcia Centeno, J. C. Percovich, A. Rebollo Roman, P. Gracia Gimeno, C. Robles Lazaro, M. Morales-Ruiz, M. Calatayud Gutierrez, S. A. Furio Collao, D. Meneses, M. A. Sampedro Nunez, V. Escudero Quesada, E. Mena Ribas, A. Sanmartin Sanchez, C. Gonzalvo Diaz, C. Lamas, R. Guerrero-Vazquez, M. del Castillo Tous, J. Serrano Gotarredona, T. Michalopoulou Alevras, E. M. Moya Mateo, F. A. Hanzu
Summary: This study evaluated the prevalence, risk factors, and progression of diabetes mellitus (DM) in patients with primary aldosteronism (PA) after targeted treatment. The results showed that about one quarter of PA patients had DM, and the risk factors for its development were similar to the general population. Both surgical and medical treatment had similar benefits in glycemic control for PA patients with DM.
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
(2023)
Review
Biochemistry & Molecular Biology
Xurong Mai, Mitsuhiro Kometani, Takashi Yoneda
Summary: This review summarizes previous studies on autonomous aldosterone production. It discusses the inhibitory effects of mineralocorticoid receptor antagonists (MRAs) on steroid synthesis and considers the possible factors of cytochrome P-450 reduction. Clinical research reveals the association between aldosterone-producing adenoma and cells containing spironolactone bodies. Furthermore, long-term treatment with MRAs has been reported to lead to spontaneous remission of primary aldosteronism in some cases.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Clinical Neurology
Namki Hong, Kyoung Jin Kim, Min Heui Yu, Seong Ho Jeong, Seunghyun Lee, Jung Soo Lim, Yumie Rhee
Summary: This study examined the risk of dementia in patients with primary aldosteronism (PA) compared to patients with essential hypertension (EH). The findings revealed that treated PA patients were more likely to develop all-cause dementia compared to EH patients. Among PA patients, those using mineralocorticoid receptor antagonists (MRA) had a higher risk, especially for vascular dementia.
ALZHEIMERS RESEARCH & THERAPY
(2023)
Article
Endocrinology & Metabolism
Yi-Lin Chen, Ting-Yan Xu, Jian-Zhong Xu, Li-Min Zhu, Yan Li, Ji-Guang Wang
Summary: In patients with primary aldosteronism, surgery and drug treatment have different effects on cardiac structure and function. Surgical removal of an adrenal gland leads to early improvement in cardiac function despite similar serum potassium normalization and blood pressure control.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Peripheral Vascular Disease
Ryo Nakamaru, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Isao Kurihara, Takashi Yoneda, Takamasa Ichijo, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Tetsuya Yamada, Hiroki Kobayashi, Kouichi Tamura, Yoshihiro Ogawa, Junji Kawashima, Nobuya Inagaki, Megumi Fujita, Kenji Oki, Kohei Kamemura, Akiyo Tanabe, Mitsuhide Naruse
Summary: The study found that female patients with bilateral primary aldosteronism have worse renal outcomes compared to male patients after receiving mineralocorticoid receptor antagonist treatment. Despite similar systolic blood pressure levels between the sexes, women experienced a greater decline in estimated glomerular filtration rate, especially during the late phase of 6 to 60 months post-treatment initiation.
Review
Endocrinology & Metabolism
Wei-Chieh Huang, Ying-Ying Chen, Yen-Hung Lin, Jeff S. Chueh
Summary: Meta-analyses confirmed the superior performance of surgical treatment over medical treatment in terms of lower incidences of composite cardiovascular outcomes and non-cure of hypertension among patients with primary aldosteronism (PA). Therefore, adrenalectomy can now be concluded as the treatment of choice for lateralized PA.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Endocrinology & Metabolism
Melpomeni Moustaki, Stavroula A. Paschou, Eleni C. Vakali, Andromachi Vryonidou
Summary: Primary aldosteronism and diabetes mellitus are clinical conditions that increase cardiovascular risk. The exact pathophysiological mechanisms linking these two conditions are not yet fully understood. This review discusses the available research data on the interactions between mineralocorticoid excess and glucose metabolism. Aldosterone plays a role in tissue glucocorticoid activity, oxidative stress, inflammation, and disruption of adipose tissue function, as well as hepatic steatosis. In the pancreas, aldosterone affects insulin secretion. Further studies are needed to explore the relationship between hypokalemia, mineralocorticoid excess, and hepatic steatosis, as well as the potential therapeutic role of pioglitazone in these conditions.
Article
Peripheral Vascular Disease
Sho Katsuragawa, Atsushi Goto, Satoru Shinoda, Kosuke Inoue, Kazuki Nakai, Jun Saito, Tetsuo Nishikawa, Yuya Tsurutani
Summary: The study suggests that reversing renin suppression with optimal mineralocorticoid receptor antagonist titration may help mitigate adverse renal outcomes in medically treated primary aldosteronism patients.
Article
Endocrinology & Metabolism
Yuta Tezuka, Adina F. Turcu
Summary: This study found that only a small percentage of patients with PA and LRH treated with MRAs in an academic outpatient practice were evaluated for target renin, and less than half of them achieved target renin. Lower baseline serum potassium, lower MRA doses, and beta-blocker use were associated with lower odds of achieving target renin in PA, while male sex was associated with target renin in LRH.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Peripheral Vascular Disease
Yuichi Yoshida, Hirotaka Shibata
Summary: Primary aldosteronism (PA) is caused by excessive secretion of aldosterone and affects the renin-angiotensin system. In Japan, a more efficient and accurate method of measuring blood aldosterone levels using chemiluminescent enzyme immunoassay is currently used. The mineralocorticoid receptor antagonist (MRA) esaxerenone has been approved for hypertension treatment with various effects, including strong antihypertensive and anti-albuminuric/proteinuric effects. MRAs have been shown to improve patient's quality of life and prevent cardiovascular events independent of their blood pressure effects.
HYPERTENSION RESEARCH
(2023)
Article
Endocrinology & Metabolism
Vin-Cent Wu, Shuo-Meng Wang, Kuo-How Huang, Yao Chou Tsai, Chieh-Kai Chan, Shao-Yu Yang, Lian-Yu Lin, Chin-Chen Chang, Ching-Chu Lu, Yen-Hung Lin, Yung-Ming Chen, Jeff S. Chueh
Summary: Long-term outcomes of unilateral primary aldosteronism (uPA) patients who underwent medical or surgery-targeted treatment showed that operated patients, especially those achieving hypertension remission, had lower risks of all-cause mortality compared to essential hypertension (EH) patients. Adrenalectomy was associated with lower mortality, MACE, and congestive heart failure risks compared to mineralocorticoid receptor antagonist (MRA) therapy in uPA patients.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Review
Biochemistry & Molecular Biology
Wei-Chih Kan, Yi-Chih Chen, Vin-Cent Wu, Chih-Chung Shiao
Summary: This review comprehensively summarizes the pathophysiological mechanisms of vancomycin-associated acute kidney injury (VA-AKI), along with biomarkers, preventive strategies, and crucial issues. The pathological manifestations of VA-AKI include acute tubular necrosis, acute tubulointerstitial nephritis (ATIN), and intratubular crystal obstruction. Factors such as high vancomycin doses, concomitant administration with other nephrotoxic antibiotics, and intermittent infusion strategies increase the risk of VA-AKI. Currently, no promising therapy is available.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Medicine, General & Internal
Tai-Shuan Lai, Chih-Cheng Hsu, Ming-Huang Lin, Vin-Cent Wu, Yung-Ming Chen
Summary: The demand for dialysis among ESKD patients in Taiwan has gradually increased in recent years, with a significant increase in the proportion of older male patients. However, the age-standardized incidence and prevalence of dialysis remained stable. During the study period, most patients chose hemodialysis as the initial treatment modality, and there was an increasing proportion of patients with dialysis duration exceeding 10 years.
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
(2022)
Article
Pharmacology & Pharmacy
Cheng-Hsuan Tsai, Xue-Ming Wu, Che-Wei Liao, Zheng-Wei Chen, Chien-Ting Pan, Yi-Yao Chang, Bo-Ching Lee, Yu-Wei Chiu, Tai-Shuan Lai, Vin-Cent Wu, Chi-Shen Hung, Yen-Hung Lin
Summary: This study found that the presence of diabetes in patients with primary aldosteronism (PA) was associated with worse baseline arterial stiffness and less recovery after treatment.
THERAPEUTIC ADVANCES IN CHRONIC DISEASE
(2022)
Article
Urology & Nephrology
Yu-Cheng Lu, Kao-Lang Liu, Vin-Cent Wu, Shuo-Meng Wang, Yen-Hung Lin, Shih-Chieh Jeff Chueh, Kwan-Dun Wu, Kuo-How Huang
Summary: The estimated glomerular filtration rate decreases significantly after adrenalectomy in patients with primary aldosteronism. Predictors for this decline include preoperative estimated glomerular filtration rate and hypokalemia.
INTERNATIONAL JOURNAL OF UROLOGY
(2022)
Article
Biochemistry & Molecular Biology
Shih-Yuan Peng, Cheng-Hsuan Tsai, Xue-Ming Wu, Hsin-Hsiu Huang, Zheng-Wei Chen, Bo-Ching Lee, Yi-Yao Chang, Chien-Ting Pan, Vin-Cent Wu, Chia-Hung Chou, Chi-Sheng Hung, Che-Wei Liao, Yen-Hung Lin
Summary: Excessive aldosterone suppressed endothelial mitochondria through the MR/mitochondrial ROS pathway, leading to endothelial dysfunction, vascular inflammation, and vascular fibrosis.
Article
Peripheral Vascular Disease
Vin-Cent Wu, Chieh-Kai Chan, Wan-Chen Wu, Kang-Yung Peng, Yuan-Shian Chang, Fang-Yu Yeh, Jiun-Yang Chiang, Yuan-Ju Lee, Kao-Lang Liu, Shuo-Meng Wang, Yen-Hung Lin, Jeff S. Chueh, TAIPAI Grp
Summary: This study aimed to investigate the effect of cortisol levels on incident new-onset type 2 diabetes mellitus in patients with primary aldosteronism. The results showed that a cortisol level ≥2.65μg/dL after 1-mg DST was a risk factor for developing new-onset type 2 diabetes mellitus. This risk was more pronounced in patients with other factors such as a higher BMI, lower estimated glomerular filtration rate, longer hypertension duration, and higher waist-to-hip ratio.
HYPERTENSION RESEARCH
(2023)
Article
Medicine, General & Internal
Chun-Fu Lai, Jung-Hua Liu, Li-Jung Tseng, Chun-Hao Tsao, Nai-Kuan Chou, Shuei-Liong Lin, Yung-Ming Chen, Vin-Cent Wu
Summary: This study used unsupervised consensus clustering to investigate the heterogeneity in dialysis-requiring sepsis-associated acute kidney injury (SA-AKI) patients. Three sub-phenotypes were identified based on 23 clinical variables, which exhibited distinct clinical manifestations at the initiation of renal replacement therapy. Among them, sub-phenotype 1, characterized by younger age, lower Charlson Comorbidity Index, higher baseline estimated glomerular filtration rate but higher severity of acute illness, had a higher risk of death and a lower probability of being free of dialysis compared to sub-phenotype 3.
ANNALS OF MEDICINE
(2023)
Letter
Endocrinology & Metabolism
Sheng-Yin Chen, Vin-cent Wu
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Vin- Cent Wu, Chieh-Kai Chan, Jeff S. Chueh, Yung-Ming Chen, Yen- Hung Lin, Chin-Chen Chang, Po-Chih Lin, Shiu-Dong Chung, TAIPAI grp
Summary: A study found that targeted treatment with MRAs or adrenalectomy in patients with PA leads to a decline in estimated glomerular filtration rate. However, the changes in biomarkers of kidney tubule health are still unclear.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Biochemistry & Molecular Biology
Ya-Yun Wang, Ying-Hung Lin, Vin-Cent Wu, Yu-Hua Lin, Chia-Yen Huang, Wei-Chi Ku, Chiao-Yin Sun
Summary: Oxidative stress is a major cause of male infertility, and the protein Klotho is involved in oxidative regulation and male fertility. This study shows that Klotho deficiency accelerates damage to sperm quality and spermatogenesis, and affects the expression of GST proteins which are important for antioxidant defense.
Article
Urology & Nephrology
Yu-Cheng Lu, Yu-Chieh Tsai, Po-Ming Chow, Wen-Ching Weng, Wei-Yi Huang, Shih-Chieh Jeff Chueh, Kao-Lang Liu, Kuo-How Huang
Summary: This study investigated the risk of subsequent malignancies in RCC patients in Taiwan and found that this risk was significantly higher than in the general population. Liver, colon, lung, bladder, and prostate cancer were the most common subsequent malignancies.
UROLOGICAL SCIENCE
(2022)
Article
Medicine, General & Internal
Heng-Chih Pan, Tao-Min Huang, Chiao-Yin Sun, Nai-Kuan Chou, Chun-Hao Tsao, Fang-Yu Yeh, Tai-Shuan Lai, Yung-Ming Chen, Vin-Cent Wu
Summary: This study analyzed the association between lactate level and prognosis in patients with Type I CRS receiving RRT, and found that a low lactate level was associated with an increased likelihood of dialysis withdrawal and a lower mortality rate. Serum lactate level can be an important factor for clinical decision-making in treating patients with Type I CRS.