Publications by authors named "Jorge Gabriel Ruiz Sanchez"

: Mild autonomous cortisol secretion (MACS) can coexist with primary aldosteronism (PA). The purpose of our study was to evaluate whether (MACS) influences parameters analyzed during adrenal venous sampling (AVS) in patients with PA. : Patients with PA from the SPAIN-ALDO Registry and the German Conn's Registry with available 1 mg-dexamethasone suppression test (DST) and AVS were included.

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  • The study aimed to assess the impact of smoking on the health profile and surgical outcomes of patients with primary aldosteronism (PA).
  • In a retrospective analysis of 881 PA patients from 36 Spanish hospitals, smokers exhibited higher rates of left ventricular hypertrophy (LVH) and larger adrenal tumors compared to non-smokers, although their blood pressure and potassium levels were similar at diagnosis.
  • The results indicated that while smoking is linked to a greater prevalence of LVH and mild autonomous cortisol secretion (MACS), it does not significantly influence hypertension cure rates after surgery for PA.
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Objective: To evaluate the efficacy of switching to once-weekly subcutaneous semaglutide in patients with type 2 diabetes mellitus (T2DM) who were previously treated with other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in a real-world setting in Spain.

Methods: The REAL Life study of SEMaglutide in Patients with Type 2 diabetes in Spain (REALSEM-SP) was conducted in four endocrinology departments in Madrid, Spain. Adult patients with T2DM who were prescribed once-weekly (OW) subcutaneous semaglutide and had been previously treated with other GLP-1 RAs were included.

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Introduction: Primary aldosteronism is the most frequent cause of hypertension although is undetected. The 2016 Endocrine Society guidelines (2016-ESG) recommendations for primary aldosteronism detection are unfulfilled. We aimed to ascertain the prevalence of primary aldosteronism, following the screening criteria endorsed by the 2016-ESG.

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  • The study aimed to analyze genetic testing rates for familial hyperaldosteronism (FH) in patients with primary aldosteronism (PA) within the SPAIN-ALDO Registry and to describe the clinical aspects of these patients.
  • Out of 855 patients with PA, only 25 (3%) underwent genetic testing for FH, with complete results for just 24, highlighting a significant gap in testing as only 14% met appropriate criteria for genetic evaluation.
  • The findings indicate that FH is rare, accounting for only 0.2% of PA cases in the registry, though it might be more prevalent (up to 4%) in patients suspected of having the condition, illustrating the need for increased genetic assessment in
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Aim: To evaluate the impact of aldosterone excess on renal function in individuals with primary aldosteronism and to compare its evolution after surgery or mineralocorticoid receptor antagonist (MRA) treatment.

Methods: A multicentre, retrospective cohort study of primary aldosteronism patients in follow-up in 36 Spanish tertiary hospitals, who underwent specific treatment for primary aldosteronism (MRA or adrenalectomy).

Results: A total of 789 patients with primary aldosteronism were included, with a median age of 57.

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Purpose: Primary aldosteronism (PA), a frequent cause of hypertension, is highly associated with cardiovascular risk and mortality. PA diagnosis is often difficult due to the need to discontinue antihypertensive medication interfering with the renin-angiotensin-aldosterone system (I-RAAS). Our objective was to ascertain diagnosis of PA through biochemical assessments during screening while maintaining I-RAAS medications.

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Primary aldosteronism (PA) is the most frequent cause of secondary hypertension and is associated with a higher cardiometabolic risk than essential hypertension. The aim of this consensus is to provide practical clinical recommendations for its surgical and medical treatment, pathology study and biochemical and clinical follow-up, as well as for the approach in special situations like advanced age, pregnancy and chronic kidney disease, from a multidisciplinary perspective, in a nominal group consensus approach of experts from the Spanish Society of Endocrinology and Nutrition (SEEN), Spanish Society of Cardiology (SEC), Spanish Society of Nephrology (SEN), Spanish Society of Internal Medicine (SEMI), Spanish Radiology Society (SERAM), Spanish Society of Vascular and Interventional Radiology (SERVEI), Spanish Society of Laboratory Medicine (SEQC(ML)), Spanish Society of Anatomic-Pathology and Spanish Association of Surgeons (AEC).

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Purpose: To compare the clinical and hormonal characteristics of patients with familial hyperaldosteronism (FH) and sporadic primary aldosteronism (PA).

Methods: A systematic review of the literature was performed for the identification of FH patients. The SPAIN-ALDO registry cohort of patients with no suspicion of FH was chosen as the comparator group (sporadic group).

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Article Synopsis
  • Primary aldosteronism (PA) is a common cause of secondary hypertension that increases cardiometabolic risks compared to essential hypertension, but it is often underdiagnosed.
  • The consensus aims to provide practical guidelines for recognizing and diagnosing PA, along with understanding the health implications of excess aldosterone.
  • This effort involves collaboration among various Spanish medical societies, emphasizing a multidisciplinary approach to improve detection and management of PA.
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Introduction: Hypoaldosteronism is characterized by hyperkalemia, and/or hypovolemic hyponatremia (HH), often accompanied by metabolic acidosis. HH is typical of hypoaldosteronism, whereas euvolemic hyponatremia (EH) is not. The purpose of the current study is to describe the characteristics of hyponatremia in hypoaldosteronism and elucidate whether EH can be considered part of the disease's spectrum.

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Introduction: Primary aldosteronism (PA) is associated with several cardiometabolic comorbidities. Specific treatment by mineralocorticoid receptor antagonists (MRA) or adrenalectomy has been reported to reduce the cardiometabolic risk. However, the cardiovascular benefit could depend on plasma renin levels in patients on MRA.

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Purpose: To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA.

Methods: A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients with confirmed unilateral or bilateral PA based on adrenal venous sampling (AVS) and/or postsurgical biochemical cure after adrenalectomy were included.

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Introduction: Admission hyponatremia, frequent in patients hospitalized for COVID-19, has been associated with increased mortality. However, although euvolemic hyponatremia secondary to the Syndrome of Inappropriate Antidiuresis (SIAD) is the single most common cause of hyponatremia in community-acquired pneumonia (CAP), a thorough and rigorous assessment of the volemia of hyponatremic COVID-19 subjects has yet to be described. We sought to identify factors contributing to mortality and hospital length-of-stay (LOS) in hospitalized COVID-19 patients admitted with hyponatremia, taking volemia into account.

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Context: Patients with obesity have an overactivated renin-angiotensin-aldosterone system (RAAS) that is associated with essential hypertension. However, the influence of obesity in primary aldosteronism (PA) is unknown.

Objective: We analyzed the effect of obesity on the characteristics of PA, and the association between obesity and RAAS components.

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  • This study looked at how common it is for people with a condition called primary aldosteronism (PA) to also have a problem with cortisol production, known as autonomous cortisol secretion (ACS).
  • They found that about 29% of patients with PA had ACS, especially those who were older or had larger tumors.
  • Despite some differences in age and tumor size, having ACS didn't change how well patients did after surgery or their overall health compared to those who only had PA.
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Objective: To evaluate the indication and the resources for the screening/diagnosis of primary aldosteronism (PA) in Endocrinology units in Spain.

Material And Methods: An anonymous 2-phase (2020/2021) online survey was conducted by the AdrenoSEEN group among SEEN members with data about screening, confirmation tests, availability of catheterisation and the treatment of PA.

Results: Eighty-eight (88) specialists completed the survey.

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Introduction: Hyponatremia is the most prevalent electrolyte disorder in the outpatient and inpatient settings. Despite this frequency, hyponatremia, including severe hyponatremia, is frequently underestimated and inadequately treated, thus highlighting the need to produce consensus documents and clinical practice guidelines geared towards improving the diagnostic and therapeutic approach to it in a structured fashion.

Material And Methods: Members of the Acqua Group of the Spanish Society of Endocrinology and Nutrition (SEEN) met using a networking methodology over a period of 20 months (between October 2019 and August 2021) with the aim of discussing and developing an updated guideline for the management of hyponatraemia.

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Introduction: Hypoaldosteronism can be congenital or acquired, isolated or part of primary adrenal insufficiency, and caused by an aldosterone deficit, resistance, or a combination of both. Reduced mineralocorticoid action can induce a decrease in urine K+ and H+ excretion and an increase in urine Na+ excretion, leading to hyperkalemia, and/or hyponatremia, often combined with metabolic acidosis. We aimed to characterize the clinical manifestations of hypoaldosteronism, and their associated factors.

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Purpose: To develop a predictive model of hypertension resolution after adrenalectomy in patients with primary aldosteronism (PA), based on their presurgical characteristics.

Methods: A retrospective multicenter study of PA patients in follow-up in 20 Spanish tertiary hospitals between 2018 and 2021 was performed (SPAIN-ALDO Register). Clinical response postadrenalectomy was classified according to the primary aldosteronism surgical outcome (PASO) consensus criteria.

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  • * A retrospective analysis of 122 hyponatremic patients showed that SC levels increased in HH patients but decreased in EH patients, indicating distinct patterns in SC changes for each condition.
  • * The findings suggest that measuring the percentage change in SC from normal sodium levels can effectively differentiate between HH and EH, with specific thresholds indicating a higher likelihood of each condition.
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Objective: The aim of this study was to evaluate the rate of adrenal venous sampling (AVS) performance in patients with primary aldosteronism (PA), the main reasons for its non-performance, and the success and complications rate of this procedure in Spain. Moreover, the concordance between CT/MRI and AVS for PA subtyping was evaluated.

Methods: A retrospective multicenter study of PA patient follow-up in 20 Spanish tertiary hospitals between 2018-2021 was performed (SPAIN-ALDO Register).

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Objective: To compare the presentation and evolution of primary aldosteronism (PA) in the elderly (≥65 years) and young patients (<65 years).

Methods: A retrospective multicenter study was performed in 20 Spanish hospitals of PA patients in follow-up between 2018 and 2021.

Results: Three hundred fifty-two patients with PA <65 years and 88 patients ≥65 years were included.

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Objective: To analyze the evolution of the cardiometabolic profile of patients with primary hyperaldosteronism (PA) after the treatment with surgery and with mineralocorticoid receptor antagonists (MRA).

Design: Retrospective multicentric study of patients with PA on follow-up in twelve Spanish centers between 2018 and 2020.

Results: 268 patients with PA treated by surgery (n = 100) or with MRA (n = 168) were included.

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