Primary aldosteronism, Cushing's syndrome, Nonfunctional adenoma
Conditions
Interventions
Sponsors
Xiangya Hospital Central South University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Inclusion criteria for the Primary Aldosteronism (PA) group: (1) Hypertension (blood pressure >=140/90 mmHg, or use of antihypertensive medication) with or without hypokalemia; (2) Aldosterone-to-renin ratio (ARR) >=30 (pg/mL)/(µIU/mL); or ARR <30 (pg/mL)/(µIU/mL) but confirmatory test positive in patients at high risk of PA; High-risk patients for PA include: unexplained hypokalemia (regardless of blood pressure level), young age, newly diagnosed hypertension, resistant or low-renin hypertension, unexplained atrial fibrillation, adrenal incidentaloma, obstructive sleep apnea, or family history of PA. 2. Inclusion criteria for the Cushing’s Syndrome (CS) group: (1) Typical manifestations of CS, or nonspecific manifestations such as hypertension or diabetes mellitus; (2) Elevated serum or urinary cortisol, and lack of suppression in the overnight 1-mg dexamethasone suppression test or the low-dose (2 mg/day) dexamethasone suppression test. Patients who meet criterion (2) and/or (1) may be considered for inclusion.
Exclusion criteria
Exclusion criteria: Exclusion criteria for primary aldosteronism: (1) Other common secondary hypertension, including hypercortisolism, renal artery stenosis, renal parenchymal hypertension, chromochromatoma, familial primary aldosteronism, and adrenal cortical carcinoma; (2) Patients with potentially positive screening results but who did not undergo confirmatory testing for various reasons; (3) Patients who did not strictly discontinue medications that significantly affect the renin-angiotensin-aldosterone system (RAAS); Exclusion criteria for Cushing's syndrome: (1) Patients with iatrogenic CS; (2) Patients with abnormal screening test results due to psychiatric disorders such as depression, alcoholism, and polycystic ovary syndrome (PCOS) that activate the HPA axis;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Postoperative blood pressure changes (systolic and diastolic; assessed at 1, 3, and 12 months);Clinical remission rate (evaluated according to PASO criteria);Postoperative cortisol and ACTH levels of CS: serum cortisol, urinary free cortisol, ACTH (assessed at 1, 3, and 12 months); | — |
Secondary
| Measure | Time frame |
|---|---|
| Postoperative renin, aldosterone, ARR, serum potassium of PA(assessed at 1, 3, and 12 months) ; | — |
Countries
China
Contacts
Public ContactXianghang Luo
Xiangya Hospital, Central South University
Outcome results
None listed