Persistent Renin Suppression After Unilateral Adrenalectomy for Primary Aldosteronism: Implications for Adverse Outcome?
Bibliographic record
Abstract
CONTEXT: Suppressed renin concentrations in medically treated patients with primary aldosteronism (PA) are associated with a worse cardiometabolic outcome compared to patients with normalized renin levels. No similar study has been conducted in patients with PA after unilateral adrenalectomy. OBJECTIVE: This study investigates the prevalence and impact of persistent renin suppression after unilateral adrenalectomy in patients with lateralized PA. METHODS: We retrospectively included 77 patients who underwent adrenalectomy for lateralized PA. All patients had postoperative renin levels available. Patients were divided into tertiles based on their direct renin concentrations (DRC) (<8 mU/L, 8-16 mU/L, >16 mU/L) at the first follow-up, approximately 6 months after surgery. Study endpoints included histopathology using CYP11B2 staining according to HISTALDO consensus, biochemical and clinical outcomes according to the PASO criteria and improvement of comorbidities and end-organ damage at short- and long-term follow-up up to 3 years postoperatively. RESULTS: Patients with DRC <8 mU/L showed a higher prevalence of non-classical histopathology compared to the other 2 tertiles (8/26 [30.8%] vs 1/25 [4%] vs 3/26 [11.5%]; P = .024) and more frequently absent or partial biochemical remission at their first follow-up (9/26 [34.6%] vs 3/25 [12.0%] vs 2/26 [7.7%]; P = .036). Nonetheless, 65.4% achieved complete biochemical remission. Clinical outcomes, including end-organ damage and comorbidities, did not differ across the tertiles. CONCLUSION: Persistent renin suppression is common 6 months after adrenalectomy and associated with worse biochemical but not clinical outcomes. More than 60% of patients with DRC <8 mU/L achieved full biochemical remission.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".