International Urology and Nephrology

, Volume 50, Issue 10, pp 1887–1895 | Cite as

Change in kidney function after unilateral adrenalectomy in patients with primary aldosteronism: identification of risk factors for decreased kidney function

  • Il Young Kim
  • In Seong Park
  • Min Jeong Kim
  • Miyeun Han
  • Harin Rhee
  • Eun Young Seong
  • Dong Won Lee
  • Soo Bong Lee
  • Ihm Soo Kwak
  • Sang Heon SongEmail author
  • Hyun Chul ChungEmail author
Nephrology - Original Paper



Glomerular filtration rate (GFR) has been reported to decrease after unilateral adrenalectomy in patients with primary aldosteronism (PA). The aim of this study was to identify clinical predictors for decreased GFR after adrenalectomy in patients with PA.


The records of 187 patients (98 patients with PA and 89 with non-PA adrenal disease) who were followed up for at least 6 months after unilateral adrenalectomy were retrospectively analyzed. Estimated GFR (eGFR) was investigated at 1, 3, and 6 months postoperatively. Preoperative risk factors for eGFR% decline at 1 month ([preoperative eGFR−eGFR at 1 month]/preoperative eGFR × 100) and postoperative CKD development were investigated.


The eGFR decreased significantly at 1 month and remained stable in the PA group. However, there were no significant changes in eGFR in the non-PA group over the 6-month period. In the PA group, a high preoperative eGFR and high aldosterone to renin ratio (ARR) were independently associated with eGFR% decline at 1 month. In patients with PA but without preoperative CKD (n = 68), a low preoperative eGFR and high ARR were independent risk factors for developing postoperative CKD. The best preoperative cut-off values of eGFR and ARR for predicting the development of postoperative CKD were ≤ 102 ml/min/1.73 m2 and ≥ 448 ng/dl:ng/ml/h, respectively.


Renal function deteriorated significantly after unilateral adrenalectomy in patients with PA. Clinicians must pay attention to postoperative renal function in PA patients at elevated risk of developing decreased kidney function.


Adrenalectomy Chronic kidney disease Glomerular filtration rate Primary aldosteronism 


Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For the retrospective type of this study formal consent is not required.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal MedicinePusan National University School of MedicineYangsanRepublic of Korea
  2. 2.Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanRepublic of Korea
  3. 3.Biomedical Research InstitutePusan National University HospitalBusanRepublic of Korea
  4. 4.Department of Internal MedicinePusan National University HospitalBusanRepublic of Korea
  5. 5.Department of Internal MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea

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