Study on the Incidence of Adrenal Insufficiency After Surgery in Primary Aldosteronism Patients Concurrent With or Without Autonomous Cortisol Secretion

Qifu Li521 enrolled

Overview

To evaluate the incidence of adrenal insufficiency after surgery in Primary aldosteronism (PA) patients concurrent with or without autonomous cortisol secretion (ACS). To assess the recovery time of postoperative adrenal insufficiency in patients. And to explore the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy.

This study is a prospective, single-center research. Primary aldosteronism patients concurrent with or without autonomous cortisol secretion who underwent adrenalectomy and completed the adrenocorticotropic hormone (ACTH) stimulation test will be included. To evaluate the incidence of adrenal insufficiency after surgery in Primary aldosteronism (PA) patients concurrent with or without autonomous cortisol secretion (ACS). To assess the recovery time of postoperative adrenal insufficiency in patients. And to explore the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy..

Study Type

OBSERVATIONAL

Enrollment

521

Conditions

Primary Aldosteronism Autonomous Cortisol Secretion Adrenal Insufficiency

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

* A confirmed diagnosis of primary aldosteronism or autonomous cortisol secretion; ② Completion of unilateral adrenal surgery; ③ Voluntary participation and obtaining informed consent. (2) Exclusion criteria * Patients with typical clinical manifestations of Cushing's syndrome; * Patients suspected of having bilateral cortisol over-secretion, such as PBMAH or PPNAD; ③ Patients with severe surgical complications, unstable postoperative condition (not due to cortical insufficiency), and difficulty completing the ACTH stimulation test; * History of ACTH allergy; * Patients requiring long-term hormone therapy for other diseases (such as autoimmune diseases); * Severe liver and kidney dysfunction (ALT ≥ 3 times the upper limit of normal; patients undergoing dialysis or with an estimated glomerular filtration rate \< 30 ml/min/m2); ⑦ History of contralateral adrenal surgery; ⑧ Patients with poor compliance who are unable to complete the study.

Outcomes

Primary Outcomes

the Incidence rate of Adrenal Insufficiency After Surgery

the Incidence rate of Adrenal Insufficiency After Surgery on the one day after surgery，which is defined as serum cortisol ≤ 390nmol/l 60 minutes after ACTH continuous infusion

Time frame: the one day after surgery

the recovery time of postoperative Adrenal Insufficiency in patients

the recovery time of postoperative Adrenal Insufficiency in patients. The patients will be completed ACTH stimulation test at 1 and 4 weeks after surgery. If serum cortisol \> 390nmol/l 60 minutes after ACTH continuous infusion，the patients will be considered as recovery

Time frame: the one day after surgery, or 1 and 4 weeks after surgery, or 3 or 6 months after surgery

the clinical characteristics and predictive indicators of patients requiring postoperative hormone replacement therapy

Time frame: 3 or 6 months after surgery