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Experimental and human data suggest that adverse cardiovascular (CV) and renal effects of aldosterone excess are dependent on concomitant dietary salt intake. Increased urinary protein (Uprot) is an early sign of nephropathy independently associated with CV risk. We have previously reported a positive association between Uprot and urinary sodium (UNa) in patients with hyperaldosteronism, but not in patients with normal aldosterone levels. We aimed to determine whether Uprot is related to UNa in patients with aldosterone-producing adenoma (APA) and whether the degree of Uprot and strength of this relationship is reduced following correction of hyperaldosteronism. Subjects with APA (n=24) underwent measurement of 24 h Uprot and UNa before and after unilateral adrenalectomy (follow-up 15.0±11.9 months). Following surgery, mean clinic systolic blood pressure fell (150.4±18.2 vs 134.5±14.5 mm Hg, P=0.0008), despite a reduction in number of antihypertensive medications, and Uprot (211.2±101.6 vs 106.0±41.8 mg per day, P

In 22 patients with unilateral primary aldosteronism (UPA), unilateral laparoscopic adrenalectomy (ADX) not only corrected hypokalemia and led to cure or improvement of hypertension, but also significantly improved quality of life (QOL).In this pilot study, QOL was evaluated prospectively using SF-36 questionnaire before and 3 and 6 months after ADX in 22 patients [14 males] with UPA who underwent ADX within the Endocrine Hypertension Research Center, Greenslopes and Princess Alexandra Hospitals, between June 2007 and June 2008.Eighty-six percent of patients were cured of hypertension, and the remainder improved. Plasma potassium normalized and, whereas renin concentration increased, plasma aldosterone, aldosterone/renin ratio, and number of antihypertensive agents decreased. Preoperatively, SF-36 scores for each QOL domain were lower for UPA patients than reported for the Australian general population, especially for physical functioning, role physical, vitality, and general health. Significant improvements were seen at 3 months in physical functioning, role physical, social functioning, role emotional, general health, mental health, and vitality and at 6 months in physical functioning, role physical, general health, role emotional, mental health, and vitality.Unilateral adrenalectomy had positive impacts not only on blood pressure and biochemical parameters, but also on QOL, which was impaired preoperatively but significantly improved by 3 months postoperatively.