イチハラ　アツヒロ   ICHIHARA Atsuhiro   市原　淳弘    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Complete remission of hypertension in a hemodialysis patient after adrenalectomy for primary aldosteronism and renal transplantation.
掲載誌名	正式名：CEN case reports 略　 称：CEN Case Rep ISSNコード：2192444921924449
巻・号・頁	7(1),pp.77-82
著者・共著者	WATANABE Daisuke†, MORIMOTO Satoshi*, TAKANO Noriyoshi, KIMURA Shihori, SEKI Yasufumi, BOKUDA Kanako, YATABE Midori, YATABE Junichi, ONIZUKA Hiromi, YAMAMOTO Tomoko, ANDO Takashi, ICHIHARA Atsuhiro
発行年月	2018/05
概要	A 64-year-old man was admitted to our hospital for the hormonal evaluation of a right adrenal adenoma. He had been diagnosed with severe proteinuria and hypertension, and antihypertensive treatment was started at the age of 60. His renal function gradually declined, and hemodialysis was begun at the age of 64. Since his blood pressure was uncontrollable and resistant to antihypertensive treatment, an endocrinological examination was performed for an incidental right adrenal mass detected by computed tomography. The results of screening, including captopril challenge and an adrenocorticotropin stimulation test for primary aldosteronism, and adrenal venous sampling suggested excessive aldosterone secretion from the right adrenal gland. Adrenalectomy was performed; his blood pressure decreased and became well-controlled with a reduced antihypertensive regimen. Furthermore, he received renal transplantation which resulted in normalization of his serum potassium level, improvement of renal function and hormonal levels such as plasma renin activity and aldosterone concentration, and satisfactory blood pressure without any antihypertensive medications. This case is extremely important to demonstrate the effects of adrenalectomy for primary aldosteronism in a hemodialysis patient. It is possible that adrenalectomy may be a useful treatment for primary aldosteronism even in patients undergoing hemodialysis. Careful long-term follow-up of our case and investigations of the efficacy of adrenalectomy in similar cases are needed to address this issue.
DOI	10.1007/s13730-017-0299-5
PMID	29288290