Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
Eur J Endocrinol. 2012 Dec 10;168(1):C1-5. doi: 10.1530/EJE-12-0899. Print 2013 Jan.
Primary aldosteronism (PA) is one of the commonest forms of curable hypertension, and use of the plasma aldosterone-to-renin ratio as a screening test has led to a more efficient identification of this condition. Both animal and human studies have indicated that PA is associated with a variety of cardiovascular and renal complications that reflect the capability of elevated aldosterone to induce tissue damage exceeding that induced by hypertension itself. Involvement of the kidney in PA is highly relevant because structural renal damage is associated with less favorable outcome, both in terms of blood pressure response to treatment and possibility to develop progressive renal failure. However, early involvement of the kidney in PA is characterized by functional changes that are largely reversible with treatment. Unilateral adrenalectomy or administration of mineralocorticoid receptor antagonists are the current options for treating an aldosterone-producing adenoma or idiopathic adrenal hyperplasia. Both treatments are effective in correcting hypertension and hypokalemia, and currently available information on their capability to prevent deterioration of renal function indicates that both surgery and medical treatment are of considerable value.
原发性醛固酮增多症（PA）是最常见的可治愈性高血压类型之一，血浆醛固酮与肾素比值的应用作为一种筛选试验，已使得这种病症的识别更为高效。动物和人体研究均表明，PA 与多种心血管和肾脏并发症相关，这反映了升高的醛固酮引起的组织损伤超过了高血压本身引起的损伤。PA 中肾脏的受累具有高度相关性，因为结构肾损伤与治疗后的血压反应和进展性肾衰竭的可能性均较差相关。然而，PA 中肾脏的早期受累表现为功能变化，这些变化在很大程度上可以通过治疗逆转。单侧肾上腺切除术或盐皮质激素受体拮抗剂的应用是治疗醛固酮分泌腺瘤或特发性肾上腺增生的当前选择。这两种治疗方法都能有效纠正高血压和低钾血症，目前关于它们预防肾功能恶化的能力的信息表明，手术和药物治疗都具有相当大的价值。
