TY - JOUR
T1 - Aldosteronomas-State of the Art
AU - McKenzie, Travis J.
AU - Lillegard, Joseph B.
AU - Young, William F.
AU - Thompson, Geoffrey B.
PY - 2009/10/1
Y1 - 2009/10/1
N2 - Primary aldosteronism (PA) is the most common cause of secondary hypertension in nonsmokers. Widespread screening of unselected hypertensives has identified PA in as many as 15% of patients. With such screening efforts using the PAC/PRA ratio and PAC, the widespread prevalence of the disease has become apparent while the relative percentage of APA has decreased. PA is confirmed by demonstrating lack of aldosterone suppressibility with sodium loading. Subtype evaluation is best achieved with high resolution CT scanning and AVS in the appropriate setting. In patients with PA and a unilateral source of aldosterone excess, laparoscopic adrenalectomy is the treatment of choice with excellent outcomes and low morbidity as compared with older open approaches. Patients with IHA, or those not amenable or agreeable to surgery, are best managed with a MR antagonist.
AB - Primary aldosteronism (PA) is the most common cause of secondary hypertension in nonsmokers. Widespread screening of unselected hypertensives has identified PA in as many as 15% of patients. With such screening efforts using the PAC/PRA ratio and PAC, the widespread prevalence of the disease has become apparent while the relative percentage of APA has decreased. PA is confirmed by demonstrating lack of aldosterone suppressibility with sodium loading. Subtype evaluation is best achieved with high resolution CT scanning and AVS in the appropriate setting. In patients with PA and a unilateral source of aldosterone excess, laparoscopic adrenalectomy is the treatment of choice with excellent outcomes and low morbidity as compared with older open approaches. Patients with IHA, or those not amenable or agreeable to surgery, are best managed with a MR antagonist.
KW - Adrenal vein sampling
KW - Aldosterone-producing adenoma
KW - Aldosteronoma
KW - Idiopathic hyperplasia
KW - Primary aldosteronism
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U2 - 10.1016/j.suc.2009.06.017
DO - 10.1016/j.suc.2009.06.017
M3 - Review article
C2 - 19836495
AN - SCOPUS:70349850949
SN - 0039-6109
VL - 89
SP - 1241
EP - 1253
JO - Surgical Clinics of North America
JF - Surgical Clinics of North America
IS - 5
ER -