Exploring the high prevalence, comorbidities, and indicators of mild autonomous cortisol secretion in primary aldosteronism: a cohort study and systematic review.

Emerging evidence has suggested a significant prevalence of mild autonomous cortisol secretion (MACS) among patients diagnosed with primary aldosteronism (PA). However, MACS's clinical characteristics and implications in PA patients remain largely unexplored. To investigate the prevalence, comorbidities, and indicators of MACS in PA patients, we conducted a retrospective cohort study including 874 PA patients with dexamethasone suppression test results in the Taiwan Primary Aldosteronism Investigators (TAIPAI) cohort between February 2011 and February 2024.

Safety and efficacy of provocative angiography for localization and treatment of gastrointestinal hemorrhage.

Purpose: Mesenteric angiography and embolization is an effective treatment of gastrointestinal bleeding. In the setting of occult bleeding, provocative maneuvers with intra-arterial vasodilators and thrombolytics can increase the diagnostic yield of angiography. This study aimed to assess the clinical outcomes of provocative angiography and factors that increase the positivity rate for active bleeding at the time of provocation.

Potential benefits of GLP-1 receptor agonist in dialysis patients with type 2 diabetes: the need for comprehensive pharmacokinetic and hemodialysis analyses.

The 2022 KDIGO guideline for diabetes management in patients with chronic kidney disease (CKD) had endorsed the use of GLP-1 receptor agonists (GLP-1RAs) for patients with CKD and type 2 diabetes who did not achieve optimal glycemic target with maximally tolerated metformin and sodium-glucose co-transporter-2 (SGLT-2) inhibitor. Our study revealed the potential benefits of GLP-1RAs in patients with dialysis-requiring acute kidney disease possibly owing to pleiotropic effects of the medicine. Nonetheless, pharmacokinetics and dialysis dose were omitted in our subgroup analyses.

Speculating suitability of partial adrenalectomy for lateralized primary aldosteronism: With emphasis on partial and complete success as optimistic outcomes.

Primary aldosteronism (PA) is the most common secondary hypertension. The best treatment for a lateralized PA is unilateral adrenalectomy. Recent studies explored partial adrenalectomy (pAdx) to reduce the risk of adrenal insufficiency.

Unilateral Primary Aldosteronism Lacking KCNJ5 Somatic Mutations is Associated with an Elevated Risk of New-Onset Diabetes Mellitus.

The association between KCNJ5 mutations and the risk of developing new-onset diabetes mellitus (NODM) in patients with unilateral primary aldosteronism (uPA) remains underexplored. To investigate this association, we conducted a longitudinal study using data from the Taiwan Primary Aldosteronism Investigation database. Our sample included 360 uPA patients with adrenalectomies between 2012 and 2017, with 191 (53.

C-terminal FGF-23 production coupling with aldosterone via FAM20C and predicting cardiovascular events in primary aldosteronism.

This study examined the involvement of fibroblast growth factor-23 (FGF-23) in primary aldosteronism (PA), a condition characterized by elevated aldosterone levels and hypertension. We recruited patients with unilateral PA (uPA) and observed increased levels of C-terminal FGF-23 (cFGF-23) and C-terminal to intact FGF-23 (iFGF-23) in patients with uPA compared with essential hypertension control participants. Elevated preoperative cFGF-23 levels were associated with adverse outcomes, including mortality and cardiovascular or kidney events.

Association of glucagon-like peptide-1 receptor agonists with cardiovascular and kidney outcomes in type 2 diabetic kidney transplant recipients.

Background: Cardiovascular disease is a leading cause of post-transplant mortality in kidney transplant recipients (KTRs), especially those with diabetes. Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular and kidney benefits in the general population with type 2 diabetes mellitus (T2DM), evidence regarding their effects in diabetic KTRs is limited.

Methods: This retrospective cohort study utilized data from the Global Collaborative Network in TriNetX, spanning January 1, 2006, to June 1, 2023.

Dipeptidyl peptidase 4 inhibitors reduce the risk of adverse outcomes after acute kidney injury in diabetic patients.

Background: Dipeptidyl peptidase 4 inhibitors (DPP4is) are considered safe for use in patients with diabetes mellitus and kidney dysfunction. We explored whether usage of DPP4is in patients who recovered from dialysis-requiring acute kidney injury (AKI) could reduce the risk of future cardiac and kidney events.

Methods: We used the TriNetX platform to investigate whether the use of DPP4is in diabetes mellitus patients within 90 days of discharge from acute kidney disease could reduce the risk of all-cause mortality, major adverse kidney events (MAKEs), major adverse cardiovascular events (MACEs), and re-dialysis.

Clinical outcomes after immune checkpoint inhibitor-associated acute kidney injury: a cohort study.

Objectives: Immune checkpoint inhibitors (ICPi) have significantly improved survival for patients with advanced cancers. However, the occurrence of ICPi-associated acute kidney injury (AKI) and its clinical impact remains unclear. This study evaluates the effects of ICPi-associated AKI (ICPi-AKI) on mortality, kidney and cardiovascular outcomes in patients undergoing ICPi treatments.

Major Adverse Cardiovascular Events in Primary Aldosteronism After Adrenalectomy or Mineralocorticoid Receptor Antagonist Treatment: A Systematic Review and Meta-Analysis.

Background: The object of this study was to investigate the incidence rate of major adverse cardiovascular event (MACE) among patients with primary aldosteronism (PA) after adrenalectomy or mineralocorticoid receptor antagonist (MRA) treatment.

Methods And Results: A systematic review and meta-analysis was conducted by searching PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and Scopus through April 15, 2024. Studies reporting the MACE incidence rate in patients with PA after treatment were included.

Kidney and Cardiovascular Outcomes Among Patients With CKD Receiving GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis of Randomized Trials.

Rationale & Objective: Glucagon-like peptide 1 (GLP-1) receptor agonists improve cardiac and kidney outcomes in patients with diabetes; however, their efficacy in individuals with reduced estimated glomerular filtration rate (eGFR) is uncertain. This study evaluated the effects of GLP-1 receptor agonists on kidney and cardiovascular (CV) outcomes in patients with chronic kidney disease (CKD).

Study Design: Systematic review and meta-analysis of randomized controlled trials (RCTs) reported through May 25, 2024.

Mild autonomous cortisol secretion in patients with aldosterone-producing adenoma and risk for cardiac remodeling and diastolic dysfunction.

Background: Mild autonomous cortisol secretion (MACS) is common in adrenal adenomas, including patients with primary aldosteronism (PA) with aldosterone-producing adenomas (APA). This study investigated the impact of MACS on cardiac remodeling and diastolic dysfunction in patients with APA.

Methods: We prospectively enrolled 483 patients with APA.

Outcomes after medical treatment for primary aldosteronism: an international consensus and analysis of treatment response in an international cohort.

Background: Primary aldosteronism can be treated medically but there is no standardised method to evaluate treatment outcomes. We aimed to develop criteria for assessing the outcomes of targeted medical treatment of primary aldosteronism, analyse outcomes across an international cohort, and identify factors associated with a complete treatment response.

Methods: An international panel of 31 primary aldosteronism experts used the Delphi method to reach consensus on the definition of complete, partial, or absent biochemical and clinical outcomes of medical treatment of primary aldosteronism.

Validating Machine Learning Models Against the Saline Test Gold Standard for Primary Aldosteronism Diagnosis.

Background: In this study, we developed and validated machine learning models to predict primary aldosteronism (PA) in hypertensive East-Asian patients, comparing their performance against the traditional saline infusion test. The motivation for this development arises from the need to provide a more efficient and standardized diagnostic approach, because the saline infusion test, although considered a gold standard, is often cumbersome, is time-consuming, and lacks uniform protocols. By offering an alternative diagnostic method, this study seeks to enhance patient care through quicker and potentially more reliable PA detection.

KCNJ5 Somatic Mutations are Associated with Better Long-Term Outcomes in Patients with Unilateral Primary Aldosteronism.

Context: The association between KCNJ5 somatic mutations and long-term outcomes in patients with operated unilateral primary aldosteronism (uPA) is unclear.

Objective: To evaluate associations among KCNJ5 somatic mutations, clinical characteristics, incident long-term cardiovascular events, and all-cause mortality in uPA patients after adrenalectomy in a large longitudinal population study.

Methods: We enrolled uPA patients from the Taiwan Primary Aldosteronism Investigation database who had undergone adrenalectomy between 2013 and 2017 and followed them until 2020.

The Captopril Challenge Test Predicts Cardiac Structure and Dysfunction in Primary Aldosteronism.

Context: The captopril challenge test (CCT) is a commonly used confirmation test that identifies the magnitude of renin- and angiotensin II-independent aldosterone production, and thus the presence and severity of primary aldosteronism (PA).

Objective: This study investigated the association between the post-CCT plasma aldosterone concentration (PAC) and cardiovascular remodeling and diastolic dysfunction.

Methods: A total of 540 PA patients with complete CCT and echocardiographic data were retrospectively analyzed.

The relationship between tissue inhibitor of metalloproteinases-1 and KCNJ5 mutation in aldosterone-producing adenoma patients.

KCNJ5 somatic mutations in aldosterone-producing adenoma (APA) are linked to higher left ventricular mass index (LVMI) and worse diastolic function. We previously identified an association between plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) and an aldosterone-induced increase in LVMI and diastolic dysfunction. This study aimed to investigate the association between the presence of KCNJ5 somatic mutation and plasma TIMP-1 in APA patients.

Diagnostic efficacy of aldosterone-to-renin ratio to screen primary aldosteronism in hypertension: a systemic review and meta-analysis.

Background: The aldosterone-to-renin ratio (ARR) is commonly used for screening primary aldosteronism (PA) in patients with difficult-to-control hypertension. Various thresholds have been proposed for the confirmatory tests, leading to inconsistency in the results.

Objectives: This study aimed to elucidate the performance of ARR screening in hypertensive patients.

Bipolar radiofrequency track cautery during abdominal biopsies: teaching points and lessons learned.

Abdominal percutaneous needle biopsies are commonly performed minimally invasive procedures to obtain tissue samples for histopathological diagnosis. Severe post-biopsy bleeding is uncommon but can be associated with prolonged hospitalization, additional interventions, morbidity, and death. Many factors may increase bleeding risk and various peri-procedural and intra-procedural strategies may minimize bleeding risk.

Visceral adiposity as a predictor of new-onset diabetes in patients with primary aldosteronism: a cohort study.

Background: Patients with primary aldosteronism (PA) exhibit a high prevalence of diabetes mellitus (DM). However, the relationship between visceral adipose tissue (VAT) and new-onset diabetes mellitus (NODM) in PA patients remains unclear.

Objectives: To explore the association between VAT and the risk of NODM in PA patients.

GAPPA: Enhancing prognosis prediction in primary aldosteronism post-adrenalectomy using graph-based modeling.

Background And Objective: Predicting postoperative prognosis is vital for clinical decision making in patients undergoing adrenalectomy (ADX). This study introduced GAPPA, a novel GNN-based approach, to predict post-ADX outcomes in patients with unilateral primary aldosteronism (UPA). The objective was to leverage the intricate dependencies between clinico-biochemical features and clinical outcomes using GNNs integrated into a bipartite graph structure to enhance prognostic prediction accuracy.

The outcomes of SGLT-2 inhibitor utilization in diabetic kidney transplant recipients.

Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) have demonstrated efficacy in reducing cardiovascular events and potentially improving kidney function in diabetic patients. This investigation analyzes the TriNetX database to assess the efficacy of SGLT-2i in diabetic kidney transplant recipients (KTR) concerning all-cause mortality, major adverse cardiac events (MACE), and major adverse kidney events (MAKE). The study includes type 2 diabetic patients over 18 who underwent kidney transplants between June 1, 2015, and June 1, 2023, with a focus on SGLT-2i use within the first three months post-transplant.

Enhanced Outcomes in Type 2 Diabetes Patients with Acute Kidney Disease Through Thiazolidinedione.

Context: Patients with diabetes are prone to acute kidney injury with the potential transition to chronic kidney disease. Few studies have investigated the role of thiazolidinedione (TZD) in these patients under acute kidney disease (AKD) phase.

Objective: We sought to examine whether using TZD during AKD could reduce the risk of future major adverse outcomes.