Department of Radiology, Medical University of Warsaw, Warsaw, Poland.
Department of Hypertension, National Institute of Cardiology, Warsaw, Poland.
Blood Press. 2021 Jun;30(3):172-179. doi: 10.1080/08037051.2020.1851590. Epub 2021 Feb 15.
Current evidence regarding renal involvement in pheochromocytoma and paraganglioma (PPGL) is scant. More accurate diagnostic methods, such as renal Doppler ultrasound for intrarenal hemodynamic studies, may provide more detailed information on renal function. It might be postulated that renal function in PPGL patients might be altered by high blood pressure and excess secretion of catecholamines. The aim of this prospective study was to assess intrarenal blood flow parameters in PPGL patients included in the prospective monoamine-producing tumour (PMT) study and to evaluate the effects of normalisation of catecholamine production after surgical treatment on long-term renal function.
Seventy consecutive patients (aged 46.5 ± 14.0 years) with PPGL were included. Forty-eight patients from the PMT study cohort, matched for age, gender, blood pressure level and presence of hypertension, served as a control group. Renal artery doppler ultrasound spectral analysis included mean resistance index (RRI) and pulsatility index (PI). Forty-seven patients completed 12 months follow-up.
There were no differences in renal parameters such as RRI, PI and kidney function between PPGL and non-PPGL patients as assessed by renal ultrasound, serum creatinine, eGFR and albumin excretion rate. No correlations between kidney function parameters, intrarenal doppler flow parameters and plasma catecholamines were observed in PPGL patients. At 12 months after surgery, no differences in creatinine level, eGFR, albumin excretion rate, RI and PI were found as compared to baseline results.
In contrast to patients with other forms of secondary hypertension, our study did not show differences in intrarenal blood flow parameters and renal function between PPGL and non-PPGL subjects. Intrarenal hemodynamics and renal function did not change after normalisation of catecholamine levels by surgical treatment.
目前有关嗜铬细胞瘤和副神经节瘤（PPGL）肾损害的证据有限。更准确的诊断方法，如肾内血流动力学研究的肾多普勒超声，可能会提供有关肾功能的更详细信息。可以假设 PPGL 患者的肾功能可能会因高血压和儿茶酚胺分泌过多而改变。本前瞻性研究的目的是评估纳入前瞻性单胺生成肿瘤（PMT）研究的 PPGL 患者的肾内血流参数，并评估手术治疗后儿茶酚胺产生正常化对长期肾功能的影响。
共纳入 70 例连续的 PPGL 患者（年龄 46.5±14.0 岁）。48 例来自 PMT 研究队列的患者，按年龄、性别、血压水平和高血压存在情况匹配，作为对照组。肾动脉多普勒超声频谱分析包括平均阻力指数（RRI）和搏动指数（PI）。47 例患者完成了 12 个月的随访。
通过肾脏超声、血清肌酐、eGFR 和白蛋白排泄率评估，PPGL 和非 PPGL 患者的肾脏参数（如 RRI、PI 和肾功能）无差异。在 PPGL 患者中，未观察到肾功能参数与肾内多普勒血流参数和血浆儿茶酚胺之间存在相关性。与基线结果相比，手术 12 个月后肌酐水平、eGFR、白蛋白排泄率、RI 和 PI 无差异。
与其他类型的继发性高血压患者相比，我们的研究未显示 PPGL 和非 PPGL 患者之间肾内血流参数和肾功能存在差异。通过手术治疗使儿茶酚胺水平正常化后，肾内血流动力学和肾功能未发生变化。
