Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Diabetes Research and Care, Capital Medical University, Beijing, China.
J Clin Hypertens (Greenwich). 2024 Sep;26(9):1116-1120. doi: 10.1111/jch.14877. Epub 2024 Aug 9.
The authors report a case of primary aldosteronism (PA) with postoperative elevation of aldosterone treated effectively by finerenone. The patient was a hypertensive man with a 30-year history of hypertension and sustained an acute myocardial infarction 5 years ago. Bilateral adrenal nodules with hyperplasia were detected and PA was confirmed. His blood potassium, direct renin concentration, and aldosterone level returned to normal after surgery of right adrenalectomy. However, 1 year after surgery, he experienced a decrease in blood potassium and an increase in aldosterone. A saline infusion test revealed an aldosterone level of 124.47 pg/mL. The patient consented to treatment with finerenone. His aldosterone and potassium levels and blood pressure have been controlled well during follow-up. This case highlights the need to screen for secondary hypertension as early as possible. Finerenone may be effective for patients with PA who are not candidates for surgery and those not relieved after surgery.
作者报告了一例原发性醛固酮增多症（PA）术后醛固酮升高，使用非奈利酮治疗有效。患者为一名高血压男性，高血压病史 30 年，5 年前发生急性心肌梗死。双侧肾上腺结节伴增生，确诊为 PA。右侧肾上腺切除术术后血钾、直接肾素浓度和醛固酮水平恢复正常。但术后 1 年，患者血钾降低，醛固酮升高。盐水输注试验显示醛固酮水平为 124.47pg/mL。患者同意接受非奈利酮治疗。随访期间，他的醛固酮和血钾水平及血压控制良好。该病例强调了尽早筛查继发性高血压的必要性。非奈利酮可能对手术不耐受或术后未缓解的 PA 患者有效。
