Risk of New-Onset Dyslipidemia After Laparoscopic Adrenalectomy in Patients with Primary Aldosteronism

Background Many patients with primary aldosteronism (PA) show a significant decline in kidney function after adrenalectomy. Thus, PA patients who undergo surgery are at greater risk of both postoperative renal damage and new-onset metabolic events associated with renal insufficiency. The aim of this...

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Bibliographic Details
Published in:World journal of surgery 2015-12, Vol.39 (12), p.2935-2940
Main Authors: Kaga, Mayuko, Utsumi, Takanobu, Tanaka, Tomoaki, Kono, Takashi, Nagano, Hidekazu, Kawamura, Koji, Kamiya, Naoto, Imamoto, Takashi, Nihei, Naoki, Naya, Yukio, Suzuki, Hiroyoshi, Ichikawa, Tomohiko
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adrenalectomy - adverse effects
Adult
Aged
Body Mass Index
Cardiac Surgery
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Chronic Kidney Disease
Dyslipidemias - etiology
Female
General Surgery
Glomerular Filtration Rate
Humans
Hyperaldosteronism - surgery
Laparoscopic Adrenalectomy
Laparoscopy
Male
Medicine
Medicine & Public Health
Middle Aged
Original Scientific Report
Primary Aldosteronism
Renal Insufficiency - etiology
Retrospective Studies
Risk Factors
Serum Lipid Level
Serum Lipid Profile
Surgery
Thoracic Surgery
Triglycerides - blood
Vascular Surgery
Young Adult
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Summary:Background Many patients with primary aldosteronism (PA) show a significant decline in kidney function after adrenalectomy. Thus, PA patients who undergo surgery are at greater risk of both postoperative renal damage and new-onset metabolic events associated with renal insufficiency. The aim of this study was to explore postoperative changes in serum lipid levels and to identify risk factors associated with postoperative new-onset dyslipidemia in PA patients. Methods The records of 57 Japanese patients who underwent unilateral laparoscopic adrenalectomy for PA were retrospectively surveyed. Clinical and biochemical data were evaluated at baseline and 12 months after surgery. Preoperative and postoperative estimated glomerular filtration (eGFR) and serum lipid profile, including triglycerides, high-density lipoprotein (HDL)-cholesterol and low-density lipoprotein (LDL)-cholesterol levels, were compared. Furthermore, uni- and multivariate analyses were performed to determine the predictors for postoperative new-onset dyslipidemia. Results A significant decrease in eGFR and deterioration of serum lipid levels was identified postoperatively in most patients. Of the 39 patients without pre-existing dyslipidemia, 18 developed new-onset dyslipidemia postoperatively. Multivariate analysis identified preoperative lower eGFR and higher body mass index as independent predictors for new-onset dyslipidemia after surgery. On univariate analyses, additional factors associated with new-onset dyslipidemia included older age, male sex, higher LDL-cholesterol, and higher LDL/HDL ratio. Conclusions PA patients had a higher risk of postoperative new-onset or progressive dyslipidemia. Clinicians should pay attention to not only follow-up of renal impairment but also total management of new-onset metabolic events associated with renal insufficiency in PA patients.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-015-3197-z