Evaluation of Intra-Renal Stiffness in Patients with Primary Aldosteronism

Intorduction Aldosterone is known to play important role in developing cardiovascular, metabolic, renal damage in hypertensive patients. Aim Aim of study was to evaluate parameters obtained by eco-color Doppler study, as non-invasive and easly performed method in asyntomatic patients with Essential Hypertension (EH) and Primary Aldosteronism (PA), without overt organ damage. Methods From April 2019 to March 2020 we consecutively enrolled 73 hypertensive subjects (48 males, 25 women), distinguished in two groups: 30 EH patients (mean age 49.5 +/- 18.7 years) and 43 PA patients (mean age 53.1 +/- 11.6 years)] [23 with aldosterone-secreting adrenal adenoma (APA), 20 with idiopathic aldosteronism (IHA)]. Results PA group showed higher renal filtration rate and 24-h urinary excretion of albumin respect to EH; moreover, in PA we found higher Pulsatility Index, altered percentage of Renale Resistance Index, Atrophy Index, and reducted parietal thickness than EH. The correlation study showed that plasma aldosterone were positively correlated with pulsatility index in PA group (right r = 0.35; p < 0.05; left r = 0.36; p < 0.05). Conclusion parameters obtained through the intra-renal eco-color Doppler examination, easly performed and non-invasive, can be useful in the early-stage identification of subclinical microvascular alterations, especially in PA, condition characterized by increased risk of cardio-vascular remodelling and metabolic alterations.

Automated summary

Aldosterone plays an important role in cardiovascular, metabolic, and renal damage in hypertensive patients. This study aimed to evaluate parameters obtained through eco-color Doppler study in asymptomatic patients with Essential Hypertension (EH) and Primary Aldosteronism (PA). The results showed that PA patients had higher renal filtration rate and albumin excretion compared to EH patients, as well as differences in various indices measured by eco-color Doppler.