{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:35:48Z","timestamp":1783488948345,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T00:00:00Z","timestamp":1636156800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The preoperative use of mineralocorticoid receptor antagonists (MRA) in patients with unilateral forms of primary aldosteronism (PA) is not standardized. The current Endocrine Society Guidelines do not specifically recommend MRA treatment before surgery. It is unclear whether preoperative MRA can optimize perioperative blood pressure and potassium control, and reduce the incidence of postoperative hyperkalaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to investigate the effect of MRA on the incidence of postoperative hyperkalaemia in addition to perioperative blood pressure and potassium concentration in patients undergoing unilateral adrenalectomy for the treatment of PA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral centres, Victoria, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>A total of 96 patients who were diagnosed with unilateral forms of PA: 73 patients (\u2018MRA\u2019 group) received preoperative MRA while 23 patients (\u2018No\u2010MRA\u2019 group) did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of postoperative hyperkalaemia was significantly higher in the \u2018No\u2010MRA\u2019 group at 2\u20134 weeks after surgery, compared to the \u2018MRA\u2019 group (35% vs. 11%, <jats:italic>p<\/jats:italic>\u2009=\u2009.014). In a logistic regression, the use of MRA significantly predicted a lower incidence of postoperative hyperkalaemia after adjusting for age, sex, baseline aldosterone\u2010to\u2010renin ratio, potassium and preoperative eGFR. Before surgery, patients in the \u2018MRA\u2019 group had normalized blood pressure and potassium concentration requiring fewer antihypertensive medications and no potassium supplements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative MRA use was associated with optimal perioperative blood pressure and normalized serum potassium in addition to a lower incidence of postoperative hyperkalaemia. MRA should be considered standard treatment for patients awaiting surgery for PA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14630","type":"journal-article","created":{"date-parts":[[2021,11,7]],"date-time":"2021-11-07T06:05:24Z","timestamp":1636265124000},"page":"40-46","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Preoperative mineralocorticoid receptor antagonist reduces postoperative hyperkalaemia in patients with Conn syndrome"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3406-5035","authenticated-orcid":false,"given":"Jinghong","family":"Zhang","sequence":"first","affiliation":[{"name":"Central Clinical School Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-6550","authenticated-orcid":false,"given":"Renata","family":"Libianto","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"},{"name":"Department of Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Monash University Endocrine Surgery Unit Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Grodski","sequence":"additional","affiliation":[{"name":"Monash University Endocrine Surgery Unit Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":false,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"},{"name":"Department of Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0104"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.08952"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00026.2015"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1472"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-801238-3.05067-4"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2013.785234"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2234"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-016-0121-y"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.5414\/CNP73392"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpw105"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00257-3"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0074"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.07.034"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2017.38"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14220"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-05-18-4587"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz150"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2019-0706"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2788"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijscr.2015.01.013","article-title":"Aldosterone deficiency after unilateral adrenalectomy for Conn's syndrome: a case report and literature review","volume":"7","author":"Yorke E","year":"2015","journal-title":"Int J Surg Case Rep"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002398"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-013-0018-3"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14630","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.14630","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T14:32:37Z","timestamp":1693233157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,6]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/cen.14630"],"URL":"https:\/\/doi.org\/10.1111\/cen.14630","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,6]]},"assertion":[{"value":"2021-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}