renal damage in patients with primary aldosteronism estimated by infrarenal stiffness evaluation

ntroduction: This study provides an overview of aldosterone's role in primary aldosteronism and its impact on renal damage. It highlights the rising prevalence of primary aldosteronism in hypertensive patients, the importance of accurate diagnosis, and the potential renal consequences. The study also focuses on evaluating renal stiffness in primary aldosteronism patients using color-Doppler ultrasonography, comparing results with essential hypertension patients to identify markers of renal damage. This research purposes to improve understanding and patient care related to primary aldosteronism's effects on the kidneys and cardiovascular health Methods: In this study, 52 patients with primary aldosteronism were recruited from January 2021 to March 2023 at University Hospital Policlinico Umberto I, "La Sapienza" University of Rome. They were compared to a control group of 40 patients with essential hypertension. The primary aldosteronism group consisted of 35 men and 17 women, with an average age of 57.1 years. The control group included 16 males and 24 females, with an average age of 40.5 years. The aim of the study was to examine the unique characteristics and diagnostic markers of primary aldosteronism. Results: This study of 92 patients compared primary hyperaldosteronism (PH) to essential hypertension (EH). Patients with PH were older and had significantly higher plasma aldosterone, lower renin activity, and higher aldosterone-renin ratios than EH patients. PH patients also exhibited higher microalbuminuria and plasma creatinine levels, while estimated glomerular filtration rates were similar. Within PH, patients with adrenal hyperplasia showed higher microalbuminuria. Renal echo-color Doppler studies in PH patients revealed reduced parietal thickness, increased pulsatility index, altered resistance index, and increased atrophy index compared to EH patients. These findings underscore the hormonal and renal differences between PH and EH, aiding in diagnosis and management. Conclusions: In conclusion, primary aldosteronism, characterized by aldosterone overproduction, impacts both the cardiovascular and renal systems. Aldosterone contributes to cardiovascular issues, such as ischemic heart disease, heart failure, and atrial fibrillation, and triggers renal damage through oxidative stress, inflammation, and fibrosis. Our study introduces a novel diagnostic tool, renal color-echo-Doppler, to detect early renal impairment. These findings underscore the need for personalized treatment in primary aldosteronism and provide a valuable method for patient selection and follow.