Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis
BackgroundUnilateral adrenalectomy is the mainstay treatment for unilateral primary aldosteronism (PA). This meta-analysis aimed to systematically analyse predictors of clinical success after unilateral adrenalectomy in PA.MethodsA search was performed using PubMed/Medline, Scopus, Embase and Web of...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.925591/full |
| _version_ | 1828148761389432832 |
|---|---|
| author | Worapaka Manosroi Pichitchai Atthakomol Pichitchai Atthakomol Phichayut Phinyo Phichayut Phinyo Piti Inthaphan |
| author_facet | Worapaka Manosroi Pichitchai Atthakomol Pichitchai Atthakomol Phichayut Phinyo Phichayut Phinyo Piti Inthaphan |
| author_sort | Worapaka Manosroi |
| collection | DOAJ |
| description | BackgroundUnilateral adrenalectomy is the mainstay treatment for unilateral primary aldosteronism (PA). This meta-analysis aimed to systematically analyse predictors of clinical success after unilateral adrenalectomy in PA.MethodsA search was performed using PubMed/Medline, Scopus, Embase and Web of Science from their inception to February 2022. Observational studies in adult PA patients which reported predictors of clinical success after unilateral adrenalectomy were included. A random-effects model was employed to pool the fully adjusted odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval (95% CI).ResultsThirty-two studies involving 5,601 patients were included. Females had a higher clinical success rate (OR 2.81; 95% CI 2.06–3.83). Older patients, patients with a longer duration of hypertension and those taking a higher number of antihypertensive medications had lower clinical success rates (OR 0.97; 95% CI 0.94–0.99, OR 0.92; 95% CI 0.88–0.96 and OR 0.44; 95% CI 0.29–0.67, respectively). Compared to non-clinical success cases, patients with clinical success had a lower body mass index (SMD -0.49 kg/m2; 95% CI -0.58,-0.39), lower systolic (SMD -0.37 mmHg; 95% CI -0.56,-0.18) and diastolic blood pressure (SMD -0.19 mmHg; 95% CI -0.33,-0.06), lower serum potassium (SMD -0.16 mEq/L; 95% CI -0.28,-0.04), higher eGFR (SMD 0.51 mL/min/1.73m2; 95% CI 0.16,0.87), a lower incidence of dyslipidemia (OR 0.29; 95% CI 0.15–0.58) and a lower incidence of diabetes mellitus (OR 0.36; 95% CI 0.22–0.59).ConclusionsMultiple predictors of clinical success after unilateral adrenalectomy in PA were identified which can help improve the quality of care for PA patients.Systematic Review Registration: INPLASY, identifier 202240129. |
| first_indexed | 2024-04-11T21:20:15Z |
| format | Article |
| id | doaj.art-4117be80acf84a5bb8f1f1d6ab5e0e7a |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-11T21:20:15Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-4117be80acf84a5bb8f1f1d6ab5e0e7a2022-12-22T04:02:39ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.925591925591Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysisWorapaka Manosroi0Pichitchai Atthakomol1Pichitchai Atthakomol2Phichayut Phinyo3Phichayut Phinyo4Piti Inthaphan5Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandOrthopaedics Department, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandClinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandClinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Internal Medicine, Nakornping Hospital, Chiang Mai, ThailandBackgroundUnilateral adrenalectomy is the mainstay treatment for unilateral primary aldosteronism (PA). This meta-analysis aimed to systematically analyse predictors of clinical success after unilateral adrenalectomy in PA.MethodsA search was performed using PubMed/Medline, Scopus, Embase and Web of Science from their inception to February 2022. Observational studies in adult PA patients which reported predictors of clinical success after unilateral adrenalectomy were included. A random-effects model was employed to pool the fully adjusted odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval (95% CI).ResultsThirty-two studies involving 5,601 patients were included. Females had a higher clinical success rate (OR 2.81; 95% CI 2.06–3.83). Older patients, patients with a longer duration of hypertension and those taking a higher number of antihypertensive medications had lower clinical success rates (OR 0.97; 95% CI 0.94–0.99, OR 0.92; 95% CI 0.88–0.96 and OR 0.44; 95% CI 0.29–0.67, respectively). Compared to non-clinical success cases, patients with clinical success had a lower body mass index (SMD -0.49 kg/m2; 95% CI -0.58,-0.39), lower systolic (SMD -0.37 mmHg; 95% CI -0.56,-0.18) and diastolic blood pressure (SMD -0.19 mmHg; 95% CI -0.33,-0.06), lower serum potassium (SMD -0.16 mEq/L; 95% CI -0.28,-0.04), higher eGFR (SMD 0.51 mL/min/1.73m2; 95% CI 0.16,0.87), a lower incidence of dyslipidemia (OR 0.29; 95% CI 0.15–0.58) and a lower incidence of diabetes mellitus (OR 0.36; 95% CI 0.22–0.59).ConclusionsMultiple predictors of clinical success after unilateral adrenalectomy in PA were identified which can help improve the quality of care for PA patients.Systematic Review Registration: INPLASY, identifier 202240129.https://www.frontiersin.org/articles/10.3389/fendo.2022.925591/fullprimary aldosteronismadrenalectomyclinical successpredictive factorsmeta-analysis |
| spellingShingle | Worapaka Manosroi Pichitchai Atthakomol Pichitchai Atthakomol Phichayut Phinyo Phichayut Phinyo Piti Inthaphan Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis Frontiers in Endocrinology primary aldosteronism adrenalectomy clinical success predictive factors meta-analysis |
| title | Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis |
| title_full | Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis |
| title_fullStr | Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis |
| title_full_unstemmed | Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis |
| title_short | Predictive factors of clinical success after adrenalectomy in primary aldosteronism: A systematic review and meta-analysis |
| title_sort | predictive factors of clinical success after adrenalectomy in primary aldosteronism a systematic review and meta analysis |
| topic | primary aldosteronism adrenalectomy clinical success predictive factors meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.925591/full |
| work_keys_str_mv | AT worapakamanosroi predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis AT pichitchaiatthakomol predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis AT pichitchaiatthakomol predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis AT phichayutphinyo predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis AT phichayutphinyo predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis AT pitiinthaphan predictivefactorsofclinicalsuccessafteradrenalectomyinprimaryaldosteronismasystematicreviewandmetaanalysis |