Endocrine Abstracts

Background: The existing consensus for patients with primary aldosteronism (PA) after unilateral adrenalectomy recommends annual follow-up to rule out persistence or recurrence of the disease.

Objectives: The aim of the study was to assess the remission rate in patients with PA ≥1 year after adrenalectomy.

Methods: Of the 41 patients who underwent adrenalectomy for PA between 2016 and 2021, 24 had available follow-up data and were included in the study. To diagnose unilateral disease we used lateralization index ≥ 4 or contralateral suppression index ≤ 0.37. Biochemical and clinical remission of PA was defined according to PASO criteria.

Results: The median age of participants was 50 years (IR 42-56), 50% were women. The median follow-up time after surgery was 5 years (IR 3-5). Aldosterone concentration before and after surgery was 998 pmol/l (IR 583-1284) and 240 pmol/l (IR 194-369), P<0.001. Plasma renin activity before surgery was 0.15 µg/l/h (IR 0.1-0.38) whereas after surgery it was 1.5 µg/l/h (IR 0.9-5.7), P<0.001. Finaly, median potassium level after surgery was significantly higher compared to the level before surgery (4.3 mmol/l vs 2.9 mmol/l ; P<0.001). At the time of data collection, 92% of patients were in complete biochemical remission, whereas 8% were in partial biochemical remission. Regarding clinical remission, the respective rates of patients who were in complete and partial remission were 54% and 38%. Only 8% of patients did not achieve clinical remission of the disease after unilateral adrenalectomy. Both patients who were in partial biochemical remission achieved complete clinical remission.

Conclusion: Our results showed that with a lateralization index ≥ 4 or contralateral suppression index ≤ 0.37, long-term, complete or partial, biochemical remission of PA was achieved in all patients after unilateral adrenalectomy. Furthermore, long-term, complete or partical, clinical remission, was achieved in 92% patients.