Abstract
Aldosterone affects fluid retention in the body by affecting how much salt and water that the kidney retains or excretes. There is limited information about the effect of prolonged aldosterone excess and treatment on body fluid in primary aldosteronism (PA) patients. In this study, body composition changes of 41 PA patients with unilateral aldosterone producing adenoma (APA) were assessed by a bio-impedance spectroscopy device. Patients with APA receiving adrenalectomy, as compared with those treated with spironolactone, had significantly lower relative overhydration (OH) and urine albumin excretion, and significantly higher urine sodium excretion four weeks after treatment. These differences dissipated 12 weeks after the initial treatment. Independent factors to predict decreased relative OH four weeks after treatment were male patients and patients who experienced adrenalectomy. Patients who underwent adrenaelctomy had significantly decreased TNF-α and increased serum potassium level when compared to patients treated with spironolactone 4 and 12 weeks after treatment. In this pilot study, we found that adrenalectomy leads to an earlier increase in renal sodium excretion and decreases in body fluid content, TNF-α, and urine albumin excretion. Adrenalectomy yields a therapeutic effect more rapidly, which has been shown to ameliorate overhydration in PA patients.
Highlights
Aldosterone affects fluid retention in the body by way of salt and water that the kidney retains or excretes
We performed a prospective study to evaluate the body composition changes as assessed by bio-impedance spectroscopy device in patients with aldosterone producing adenoma (APA) treated with either adrenalectomy or spironolactone
Plasma aldosterone concentration (PAC) in operative group decreased over time and that of spironolactone group increased over time
Summary
Aldosterone affects fluid retention in the body by way of salt and water that the kidney retains or excretes. There is limited information about the effect of prolonged aldosterone excess and treatment on body fluid. The clinical assessment of fluid status is relatively difficult because physical signs of edema are of limited value in diagnosing excess intravascular volume[7]. Bioimpedance spectroscopy is a simple and effective approach for the assessment of fluid status and for evaluating fat mass and lean mass[8,9]. We performed a prospective study to evaluate the body composition changes as assessed by bio-impedance spectroscopy device in patients with APA treated with either adrenalectomy or spironolactone. We assessed the changes of cardiac dysfunction, fluid overload, and renal function by novel biomarkers, and of the levels urine sodium and potassium excretion before and after treatment
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