Adrenal Insufficiency, Autonomous Cortisol Secretion, Primary Aldosteronism
Conditions
Keywords
Primary Aldosteronism, Autonomous Cortisol Secretion, Adrenal Insufficiency, ACTH stimulation test
Brief summary
To evaluate the incidence of adrenal insufficiency after surgery in Primary aldosteronism (PA) patients concurrent with or without autonomous cortisol secretion (ACS). To assess the recovery time of postoperative adrenal insufficiency in patients. And to explore the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy.
Detailed description
This study is a prospective, single-center research. Primary aldosteronism patients concurrent with or without autonomous cortisol secretion who underwent adrenalectomy and completed the adrenocorticotropic hormone (ACTH) stimulation test will be included. To evaluate the incidence of adrenal insufficiency after surgery in Primary aldosteronism (PA) patients concurrent with or without autonomous cortisol secretion (ACS). To assess the recovery time of postoperative adrenal insufficiency in patients. And to explore the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy..
Interventions
DIAGNOSTIC_TESTcomplete ACTH stimulation test the day after surgery and complete ACTH stimulation test 1 or 4 week for patients with Adrenal Insufficiency
patients complete ACTH stimulation test on the one day after surgery and complete ACTH stimulation test 1 or 4 week for patients with Adrenal Insufficiency
Sponsors
Qifu Li
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* A confirmed diagnosis of primary aldosteronism or autonomous cortisol secretion; ② Completion of unilateral adrenal surgery; ③ Voluntary participation and obtaining informed consent. (2)
Exclusion criteria
* Patients with typical clinical manifestations of Cushing's syndrome; * Patients suspected of having bilateral cortisol over-secretion, such as PBMAH or PPNAD; ③ Patients with severe surgical complications, unstable postoperative condition (not due to cortical insufficiency), and difficulty completing the ACTH stimulation test; * History of ACTH allergy; * Patients requiring long-term hormone therapy for other diseases (such as autoimmune diseases); * Severe liver and kidney dysfunction (ALT ≥ 3 times the upper limit of normal; patients undergoing dialysis or with an estimated glomerular filtration rate \< 30 ml/min/m2); ⑦ History of contralateral adrenal surgery; ⑧ Patients with poor compliance who are unable to complete the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the Incidence rate of Adrenal Insufficiency After Surgery | the one day after surgery | the Incidence rate of Adrenal Insufficiency After Surgery on the one day after surgery，which is defined as serum cortisol ≤ 390nmol/l 60 minutes after ACTH continuous infusion |
| the recovery time of postoperative Adrenal Insufficiency in patients | the one day after surgery, or 1 and 4 weeks after surgery, or 3 or 6 months after surgery | the recovery time of postoperative Adrenal Insufficiency in patients. The patients will be completed ACTH stimulation test at 1 and 4 weeks after surgery. If serum cortisol \> 390nmol/l 60 minutes after ACTH continuous infusion，the patients will be considered as recovery |
| the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy | 3 or 6 months after surgery | the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy |
Countries
China
Contacts
CONTACTLi Qifu, PhD
Outcome results
None listed