Language
English
Publication Date
8-13-2024
Journal
The Journal of Clinical Endocrinology & Metabolism
DOI
10.1210/clinem/dgad765
PMID
38157409
PMCID
PMC11318994
PubMedCentral® Posted Date
12-29-2023
PubMedCentral® Full Text Version
Post-print
Abstract
Context: Patients with nonfunctioning adrenal adenomas (NFA) and mild autonomous cortisol secretion (MACS) demonstrate an increased risk of chronic kidney disease (CKD); however, factors associated with CKD are unknown.
Objective: We aimed to identify the factors associated with CKD and assess the effect of adrenalectomy on kidney function in patients with NFA or MACS.
Methods: A single-center cohort study of patients with NFA and MACS, 1999 to 2020, was conducted. MACS was diagnosed based on post dexamethasone suppression test (DST) cortisol greater than or equal to 1.8 mcg/dL. Age, sex, dysglycemia, hypertension, therapy with statin, angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker were included in the multivariable analysis. Outcomes included estimated glomerular filtration rate (eGFR) at the time of diagnosis with MACS or NFA and postadrenalectomy delta eGFR.
Results: Of 972 patients, 429 (44%) had MACS and 543 (56%) had NFA. At the time of diagnosis, patients with MACS had lower eGFR (median 79.6 vs 83.8 mL/min/1.73 m2; P < .001) than patients with NFA. In a multivariable analysis, factors associated with lower eGFR were older age, hypertension, and higher DST. In 204 patients (MACS: 155, 76% and NFA: 49, 24%) treated with adrenalectomy, postadrenalectomy eGFR improved in both groups starting at 18 months up to 3.5 years of follow-up. Factors associated with increased eGFR were younger age, lower preadrenalectomy eGFR, and longer follow-up period.
Conclusion: DST cortisol is an independent risk factor for lower eGFR in patients with adrenal adenomas. Patients with both MACS and NFA demonstrate an increase in eGFR post adrenalectomy, especially younger patients with lower eGFR pre adrenalectomy.
Keywords
Humans, Male, Female, Middle Aged, Retrospective Studies, Glomerular Filtration Rate, Adrenalectomy, Adult, Adrenal Gland Neoplasms, Renal Insufficiency, Chronic, Hydrocortisone, Aged, Adrenocortical Adenoma, Adenoma, Risk Factors, Kidney, Follow-Up Studies, mild autonomous cortisol secretion, MACS, outcome, chronic kidney disease, glomerular filtration rate
Published Open-Access
yes
Recommended Citation
Rahimi, Leili; Kittithaworn, Annop; Gregg Garcia, Raul; et al., "Kidney Function in Patients With Adrenal Adenomas: A Single-Center Retrospective Cohort Study" (2024). Faculty, Staff and Students Publications. 8391.
https://digitalcommons.library.tmc.edu/baylor_docs/8391