原发性醛固酮增多症治疗后肾脏结局的研究 现状

Current Status of Research on Renal Outcomes after Treatment of Primary Aldosteronism

摘要: 原发性醛固酮增多症(primary aldosteronism, PA)是一种常见的继发性高血压，其诊断和治疗方面近年来取得显著进展，但无论是通过手术还是药物治疗，在纠正高醛固酮状态后，患者常出现肾功能的短期下降，同时对于PA患者治疗后长期肾脏结局仍需进一步研究。因此本文旨在系统综述PA不同治疗方式(手术与药物)对肾功能产生的短期及长期影响。通过剖析PA患者治疗后肾功能动态变化的机制，辨析其临床意义，并综合评估远期肾脏风险，为临床实践中治疗策略的优化、患者风险的分层管理以及未来研究方向提供依据。

Abstract: Primary aldosteronism (PA) is a common cause of secondary hypertension. In recent years, significant progress has been made in its diagnosis and treatment. However, following correction of the hyperaldosteronism, whether through surgery or medication, patients often experience a short-term decline in renal function. Furthermore, the long-term renal outcomes in patients with PA after treatment warrant further investigation. Therefore, this article aims to systematically review the short- and long-term effects of different treatment modalities (surgery versus medication) for PA on renal function. By analyzing the mechanisms underlying the dynamic changes in renal function post-treatment, we seek to elucidate their clinical significance and comprehensively evaluate the long-term renal risks. This review intends to provide a basis for optimizing treatment strategies, stratifying patient risk management in clinical practice, and guiding future research directions.