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. 2017 Aug;14(2):1235-1240.
doi: 10.3892/etm.2017.4588. Epub 2017 Jun 13.

Kidney dysfunction following adrenalectomy in autosomal dominant polycystic kidney disease complicated with primary aldosteronism: A case report

Hiroyuki Hirai  1   2 , Makoto Kanno  1 , Tsuyoshi Watanabe  1   3 , Hiroaki Satoh  1   4
Affiliations

Kidney dysfunction following adrenalectomy in autosomal dominant polycystic kidney disease complicated with primary aldosteronism: A case report

Hiroyuki Hirai et al. Exp Ther Med. 2017 Aug.

Abstract

The present study reported a case of autosomal dominant polycystic kidney disease complicated with primary aldosteronism in a 49-year-old woman. The patient was referred for refractory hypertension. Laboratory examinations revealed low potassium and renin levels. Computed tomography indicated a right adrenal tumor and multiple renal cysts. Adrenal vein sampling revealed a high aldosterone level on the side of the tumor. The patient was diagnosed with autosomal dominant polycystic kidney disease complicated by primary aldosteronism and adrenalectomy was performed. Over the following 7 months, the estimated glomerular filtration rate decreased from 76 to 48 ml/min/1.73 m2, which was attributed to glomerular hyperfiltration correction induced by hyperaldosteronism remission, indicating kidney dysfunction. Clinicians must therefore monitor for the unmasking of kidney dysfunction following adrenalectomy in such cases.

Keywords: adrenalectomy; autosomal dominant polycystic kidney disease; kidney dysfunction; primary aldosteronism.

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Figures

Figure 1.
Figure 1.
Abdominal computed tomography and magnetic resonance imaging. Abdominal computed tomography indicated (A) a right adrenal (arrow) tumor ~1.0 cm in size and multiple cysts in the liver and (B) the kidneys. (C) Abdominal T2-weighted coronal magnetic resonance image identified a right adrenal (arrow) tumor ~1.0 cm in size and multiple cysts in the liver and the bilateral kidneys.
Figure 1.
Figure 1.
Abdominal computed tomography and magnetic resonance imaging. Abdominal computed tomography indicated (A) a right adrenal (arrow) tumor ~1.0 cm in size and multiple cysts in the liver and (B) the kidneys. (C) Abdominal T2-weighted coronal magnetic resonance image identified a right adrenal (arrow) tumor ~1.0 cm in size and multiple cysts in the liver and the bilateral kidneys.
Figure 2.
Figure 2.
Clinical course. Although the estimated glomerular filtration rate declined rapidly for ~7 months after adrenalectomy, the rate of decline thereafter was much slower, consistent with the natural clinical course of autosomal dominant polycystic kidney disease.
See this image and copyright information in PMC

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