Medizinische Klinik und Poliklinik IV, Klinikum der Universität, LMU München, München, Germany.
Department of Nephrology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
Eur J Endocrinol. 2018 Jun;178(6):605-611. doi: 10.1530/EJE-17-0978. Epub 2018 Apr 10.
Primary aldosteronism (PA) is the most common endocrine form of arterial hypertension. The German Conn's Registry's purpose is to improve treatment outcomes of PA. We assessed whether key clinical, biochemical and epidemiological characteristics of newly diagnosed PA cases have changed over time, potentially indicating a different screening and referral practice in Germany evolving from 2008 to 2016.
The German Conn's Registry is a multicenter database prospectively analyzing morbidity and long-term outcome of patients with PA.
Phenotypic changes between three year periods were calculated using Mann-Whitney tests and Kruskal-Wallis tests for independent variables.
Over three time periods from 2008 to 2016, we noted a relative decrease of unilateral PA cases (67 vs 43%). Significantly more females were diagnosed with PA (33 vs 43%). Median daily defined drug doses decreased (3.1 vs 2.0) in the presence of unchanged SBP (150 vs 150 mmHg), plasma aldosterone (199 vs 173 ng/L) and PRC (3.2 vs 3.2 U/L). Median ARR values decreased (70 vs 47 ng/U) and median potassium levels at diagnosis (3.5 vs 3.7 mmol/L) increased as the percentage of normokalemic patients (25 vs 41%), indicating milder forms of PA.
Our results are in accordance with an increased screening intensity for PA. We identified a trend toward diagnosing milder forms, increasingly more females and less unilateral cases of PA.
原醛症（PA）是最常见的内分泌性高血压。德国康恩氏登记处的目的是改善 PA 的治疗效果。我们评估了新诊断的 PA 病例的关键临床、生化和流行病学特征是否随时间发生变化，这可能表明德国的筛查和转诊实践有所不同，从 2008 年到 2016 年有所演变。
德国康恩氏登记处是一个多中心数据库，前瞻性分析 PA 患者的发病率和长期预后。
使用 Mann-Whitney U 检验和 Kruskal-Wallis 检验计算三年期间的表型变化。
在 2008 年至 2016 年的三个时间段中，我们注意到单侧 PA 病例的相对减少（67 例对 43%）。诊断为 PA 的女性明显增多（33%对 43%）。在收缩压（150 对 150mmHg）、血浆醛固酮（199 对 173ng/L）和 PRC（3.2 对 3.2U/L）不变的情况下，每日定义药物剂量中位数降低（3.1 对 2.0）。ARR 值中位数（70 对 47ng/U）降低，诊断时血钾中位数（3.5 对 3.7mmol/L）升高，正常血钾患者的比例（25%对 41%）升高，提示 PA 表现形式较轻。
我们的结果与 PA 筛查强度增加一致。我们发现诊断出的 PA 形式较轻、女性患者增多、单侧病例减少的趋势。
