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常染色体显性遗传性多囊肾病合并原发性醛固酮增多症患者肾上腺切除术后的肾功能障碍:一例报告

Kidney dysfunction following adrenalectomy in autosomal dominant polycystic kidney disease complicated with primary aldosteronism: A case report.

作者信息

Hirai Hiroyuki, Kanno Makoto, Watanabe Tsuyoshi, Satoh Hiroaki

机构信息

Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.

Department of Internal Medicine, Shirakawa Kosei General Hospital, Shirakawa, Fukushima 961-0005, Japan.

出版信息

Exp Ther Med. 2017 Aug;14(2):1235-1240. doi: 10.3892/etm.2017.4588. Epub 2017 Jun 13.

Abstract

The present study reported a case of autosomal dominant polycystic kidney disease complicated with primary aldosteronism in a 49-year-old woman. The patient was referred for refractory hypertension. Laboratory examinations revealed low potassium and renin levels. Computed tomography indicated a right adrenal tumor and multiple renal cysts. Adrenal vein sampling revealed a high aldosterone level on the side of the tumor. The patient was diagnosed with autosomal dominant polycystic kidney disease complicated by primary aldosteronism and adrenalectomy was performed. Over the following 7 months, the estimated glomerular filtration rate decreased from 76 to 48 ml/min/1.73 m, which was attributed to glomerular hyperfiltration correction induced by hyperaldosteronism remission, indicating kidney dysfunction. Clinicians must therefore monitor for the unmasking of kidney dysfunction following adrenalectomy in such cases.

摘要

本研究报告了一例49岁女性常染色体显性多囊肾病合并原发性醛固酮增多症的病例。该患者因难治性高血压前来就诊。实验室检查显示低钾和肾素水平降低。计算机断层扫描显示右侧肾上腺肿瘤和多个肾囊肿。肾上腺静脉采血显示肿瘤侧醛固酮水平升高。该患者被诊断为常染色体显性多囊肾病合并原发性醛固酮增多症,并接受了肾上腺切除术。在接下来的7个月里,估计肾小球滤过率从76降至48 ml/min/1.73 m²,这归因于醛固酮增多症缓解引起的肾小球高滤过纠正,提示肾功能不全。因此,临床医生在这类病例中进行肾上腺切除术后必须监测肾功能不全的暴露情况。

相似文献

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Autosomal dominant polycystic kidney disease with primary hyperaldosteronism.
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本文引用的文献

1
Blood pressure in early autosomal dominant polycystic kidney disease.常染色体显性遗传性多囊肾病早期的血压情况
N Engl J Med. 2014 Dec 11;371(24):2255-66. doi: 10.1056/NEJMoa1402685. Epub 2014 Nov 15.
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A young patient with a family history of hypertension.一位有高血压家族病史的年轻患者。
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Nat Rev Nephrol. 2011 Jan;7(1):55-60. doi: 10.1038/nrneph.2010.158. Epub 2010 Nov 23.
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Autosomal dominant polycystic kidney disease: the last 3 years.常染色体显性多囊肾病:过去三年
Kidney Int. 2009 Jul;76(2):149-68. doi: 10.1038/ki.2009.128. Epub 2009 May 20.

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