Electrolyte Disturbance, Primary Hyperaldosteronism
Conditions
Keywords
Hyperaldosteronism, Potassium, Magnetic Resonance Imaging
Brief summary
Recent human studies found tissue sodium storage in patients with hyperaldosteronism that could be detected non-invasively by 23Na-MRI. Tissue sodium accumulation could be mobilized upon treatment of hyperaldosteronism. Besides, former animal studies applying chemical electrolyte analysis indicate that this aldosterone induced sodium storage might be accompanied by intracellular potassium loss. Wether such an intracellular tissue potassium loss occurs in vivo in patients with hyperaldosteronism and if this deficiency can be corrected by treatment is unclear. The investigators will employ 39K-MR Imaging at 7Tesla to further assess this hypothesis.
Detailed description
Patients diagnosed with primary hyperaldosteronism (PA) will be prospetively investigated using 23Na-MRI and 39K-MRI at 7 Tesla to assess tissue sodium and potassium content (prospective observational study). Measurements will be conducted before treatment of hyperaldosteronism and three to four months after adrenal surgery or medical treatment (Spironolactone or Eplerenone). Furthermore, blood pressure, body water distribution (by bioimpedance spectroscopy), pulse wave velocity and serum electrolytes will be assessed. Additionally, we will conduct a case-control study and compare PA patients before treatment with age- and gender matched healthy control participants. In this study group 23Na-MRI and 39K-MRI at 7 Tesla will be conducted to assess tissue sodium and potassium content using the same MRI protocols as in PA patients. Blood pressure, body water distribution (by bioimpedance spectroscopy), pulse wave velocity and serum electrolytes will be also examined.
Interventions
PROCEDURESurgical Treatment of Primary Aldosteronism
Surgery of an unilateral adrenal disease
DRUGDrug treatment of Primary Aldosteronism
Treatment of Primary Aldosteronism with Spironolactone or Eplerenone.
Sponsors
University of Erlangen-Nürnberg Medical School
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
Yes
Inclusion criteria
for patients with Primary Aldosteronism: * Primary Aldosteronism diagnosed according to the endocrinological guideline (J Clin Endocrinology & Metabolism, May 2016) without specific medication * Age \> 18 years
Exclusion criteria
for patients with Primary Aldosteronism: * Chronic kidney disease ≤ 3b (estimated GFR \<45 ml/min according to CKD-EPI) * Active malignancy * Severe congestive heart failure (NYHA III and IV) * Liver cirrhosis (Child B and C) * Acute infection * Recent major surgical procedures (\<3 months) * Pregnancy * Contraindications for MRI measurements: cardiac pacemaker, claustrophobia, etc. Inclusion Criteria for healthy control participants: \- Age \> 18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Tissue potassium content | 3-6 months after intervention | 1. Change in tissue potassium content measured by MRI before and after treatment of Primary Aldosteronism 2. Difference in tissue potassium content between patients with Primary Aldosteronism before treatment and healthy control subjects |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tissue sodium content | 3-6 months after intervention | 1. Change in tissue sodium content measured by MRI before and after treatment of Primary Aldosteronism 2. Difference in tissue sodium content between patients with Primary Aldosteronism before treatment and healthy control subjects |
| Blood pressure | 3-6 months after intervention | Change in blood pressure (systolic/diastolic/mean) before and after treatment of Primary Aldosteronism |
| Water balance | 3 - 6 months after intervention | 1. Change in water distribution (intra-/extracellular water, total water, overhydration) assessed by bioimpedance spectroscopy before and after treatment of Primary Aldosteronism 2. Difference in water distribution (intra-/extracellular water, total water, overhydration) assessed by bioimpedance spectroscopy between patients with Primary Aldosteronism before treatment and healthy control subjects |
| Pulse wave velocity | 3 - 6 months after intervention | 1. Change in pulse wave velocity measured by SphygmoCor before and after treatment of Primary Aldosteronism 2. Difference in pulse wave velocity between patients with Primary Aldosteronism before treatment and healthy control subjects |
Countries
Germany
Outcome results
None listed