{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:17:08Z","timestamp":1793197028105,"version":"4.5.0"},"reference-count":22,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK121888"],"award-info":[{"award-number":["K23DK121888"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R03DK132121"],"award-info":[{"award-number":["R03DK132121"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Patients with nonfunctioning adrenal adenomas (NFA) and mild autonomous cortisol secretion (MACS) demonstrate an increased risk of chronic kidney disease (CKD); however, factors associated with CKD are unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to identify the factors associated with CKD and assess the effect of adrenalectomy on kidney function in patients with NFA or MACS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A single-center cohort study of patients with NFA and MACS, 1999 to 2020, was conducted. MACS was diagnosed based on post dexamethasone suppression test (DST) cortisol greater than or equal to 1.8\u2005mcg\/dL. Age, sex, dysglycemia, hypertension, therapy with statin, angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker were included in the multivariable analysis. Outcomes included estimated glomerular filtration rate (eGFR) at the time of diagnosis with MACS or NFA and postadrenalectomy delta eGFR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 972 patients, 429 (44%) had MACS and 543 (56%) had NFA. At the time of diagnosis, patients with MACS had lower eGFR (median 79.6 vs 83.8\u2005mL\/min\/1.73\u2005m2; P &amp;lt; .001) than patients with NFA. In a multivariable analysis, factors associated with lower eGFR were older age, hypertension, and higher DST. In 204 patients (MACS: 155, 76% and NFA: 49, 24%) treated with adrenalectomy, postadrenalectomy eGFR improved in both groups starting at 18 months up to 3.5 years of follow-up. Factors associated with increased eGFR were younger age, lower preadrenalectomy eGFR, and longer follow-up period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>DST cortisol is an independent risk factor for lower eGFR in patients with adrenal adenomas. Patients with both MACS and NFA demonstrate an increase in eGFR post adrenalectomy, especially younger patients with lower eGFR pre adrenalectomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad765","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T19:32:07Z","timestamp":1703878327000},"page":"e1750-e1758","source":"Crossref","is-referenced-by-count":9,"title":["Kidney Function in Patients With Adrenal Adenomas: A Single-Center Retrospective Cohort Study"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3908-8324","authenticated-orcid":false,"given":"Leili","family":"Rahimi","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-3355","authenticated-orcid":false,"given":"Annop","family":"Kittithaworn","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Gregg Garcia","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7156-6229","authenticated-orcid":false,"given":"Jasmine","family":"Saini","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prerna","family":"Dogra","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Kattah","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9332-2524","authenticated-orcid":false,"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic , Rochester, MN 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"2024081223520093600_dgad765-B1","doi-asserted-by":"crossref","first-page":"e973","DOI":"10.1210\/clinem\/dgz284","article-title":"Adrenal incidentalomas are tied to increased risk of diabetes: findings from a prospective study","volume":"105","author":"Reimondo","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"2024081223520093600_dgad765-B2","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/S2213-8587(20)30314-4","article-title":"Epidemiology of adrenal tumours in olmsted county, Minnesota, USA: a population-based cohort study","volume":"8","author":"Ebbehoj","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"11","key":"2024081223520093600_dgad765-B3","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.1210\/clinem\/dgab468","article-title":"Cardiometabolic outcomes and mortality in patients with adrenal adenomas in a population-based setting","volume":"106","author":"Zhang","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2024081223520093600_dgad765-B4","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/S2213-8587(13)70211-0","article-title":"Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing's syndrome: a 15-year retrospective study","volume":"2","author":"Di Dalmazi","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"2024081223520093600_dgad765-B5","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-16-0467","article-title":"Management of adrenal incidentalomas: european society of endocrinology clinical practice guideline in collaboration with the European network for the study of adrenal tumors","volume":"175","author":"Fassnacht","year":"2016","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"2024081223520093600_dgad765-B6","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European society of endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European network for the study of adrenal tumors","volume":"189","author":"Fassnacht","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2024081223520093600_dgad765-B7","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/cpt.1551","article-title":"Modern management of mild autonomous cortisol secretion","volume":"106","author":"Delivanis","year":"2019","journal-title":"Clin Pharmacol Ther"},{"issue":"3","key":"2024081223520093600_dgad765-B8","doi-asserted-by":"crossref","first-page":"325","DOI":"10.7326\/M21-1737","article-title":"Cardiometabolic disease burden and steroid excretion in benign adrenal tumors: a cross-sectional multicenter study","volume":"175","author":"Prete","year":"2022","journal-title":"Ann Intern Med"},{"issue":"9","key":"2024081223520093600_dgad765-B9","doi-asserted-by":"crossref","first-page":"e3307","DOI":"10.1210\/clinem\/dgaa410","article-title":"Frailty in patients with mild autonomous cortisol secretion is higher than in patients with nonfunctioning adrenal tumors","volume":"105","author":"Singh","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2024081223520093600_dgad765-B10","doi-asserted-by":"crossref","first-page":"107","DOI":"10.7326\/M18-3630","article-title":"Natural history of adrenal incidentalomas with and without mild autonomous cortisol excess: a systematic review and meta-analysis","volume":"171","author":"Elhassan","year":"2019","journal-title":"Ann Intern Med"},{"issue":"5","key":"2024081223520093600_dgad765-B11","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1530\/EJE-21-0458","article-title":"Abnormal body composition in patients with adrenal adenomas","volume":"185","author":"Delivanis","year":"2021","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"2024081223520093600_dgad765-B12","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1093\/ejendo\/lvad113","article-title":"High prevalence of frailty in patients with adrenal adenomas and adrenocortical hormone excess: a cross-sectional multi-centre study with prospective enrolment","volume":"189","author":"Dogra","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2024081223520093600_dgad765-B13","doi-asserted-by":"crossref","first-page":"S88","DOI":"10.1093\/ejendo\/lvad134","article-title":"Comorbidities in mild autonomous cortisol secretion and the effect of treatment: systematic review and meta-analysis","volume":"189","author":"Pelsma","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"8","key":"2024081223520093600_dgad765-B14","doi-asserted-by":"crossref","first-page":"533","DOI":"10.7326\/M16-0547","article-title":"\u201cNonfunctional\u201d adrenal tumors and the risk for incident diabetes and cardiovascular outcomes: a cohort study","volume":"165","author":"Lopez","year":"2016","journal-title":"Ann Intern Med"},{"issue":"4","key":"2024081223520093600_dgad765-B15","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1507\/endocrj.EJ19-0478","article-title":"Overestimation of glomerular filtration rate calculated from serum creatinine as compared with cystatin C in patients with subclinical hypercortisolism: hyogo adrenal metabolic registry","volume":"67","author":"Naka","year":"2020","journal-title":"Endocr J"},{"key":"2024081223520093600_dgad765-B16","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3389\/fendo.2019.00572","article-title":"Overweight patients less improved kidney function after laparoscopic surgery for adrenocortical adenoma with excess cortisol secretion","volume":"10","author":"Numakura","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"12","key":"2024081223520093600_dgad765-B17","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1111\/iju.15007","article-title":"Predictors of renal function after adrenalectomy in patients with cushing or subclinical cushing syndrome","volume":"29","author":"Kufukihara","year":"2022","journal-title":"Int J Urol"},{"issue":"6","key":"2024081223520093600_dgad765-B18","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1530\/eje.1.02040","article-title":"Glomerular filtration rate in patients with Cushing's disease: a matched case-control study","volume":"153","author":"Haentjens","year":"2005","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"2024081223520093600_dgad765-B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ygcen.2010.07.004","article-title":"Cushing's syndrome, glucocorticoids and the kidney","volume":"169","author":"Smets","year":"2010","journal-title":"Gen Comp Endocrinol"},{"issue":"1-2","key":"2024081223520093600_dgad765-B20","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/0009-8981(90)90283-X","article-title":"Heterogeneity of urinary albumin from diabetic patients","volume":"190","author":"Hayashi","year":"1990","journal-title":"Clin Chim Acta"},{"key":"2024081223520093600_dgad765-B21","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.kisu.2021.11.004","article-title":"Nonepithelial mineralocorticoid receptor activation as a determinant of kidney disease","volume":"12","author":"Nakamura","year":"2022","journal-title":"Kidney Int Suppl (2011)"},{"issue":"3","key":"2024081223520093600_dgad765-B22","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1210\/clinem\/dgab724","article-title":"Interpretation of abnormal dexamethasone suppression test is enhanced with use of synchronous free cortisol assessment","volume":"107","author":"Genere","year":"2022","journal-title":"J Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgad765\/56642104\/dgad765.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/9\/e1750\/58769523\/dgad765.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/9\/e1750\/58769523\/dgad765.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T01:08:35Z","timestamp":1723511315000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/109\/9\/e1750\/7503883"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,29]]},"references-count":22,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,12,29]]},"published-print":{"date-parts":[[2024,8,13]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgad765","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2023,12,29]]}}}