{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:26:15Z","timestamp":1785875175307,"version":"3.56.0"},"reference-count":41,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Sociedad Espa\u00f1ola de Endocrinolog\u00eda y Nutrici\u00f3n"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Perioperative use of mineralocorticoid receptor antagonists (MRA) in patients with unilateral primary aldosteronism (PA) awaiting surgery is not well standardized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to compare the risk of postoperative complications and surgical outcomes between PA patients treated with MRA prior to adrenalectomy and those not pretreated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adrenalectomized patients for unilateral PA from the SPAIN-ALDO registry, with clinical, hormonal, and treatment information before and after adrenalectomy, were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 355 surgically treated patients were included; 76.9% (n = 273) received presurgical treatment with MRA (spironolactone [64.5%], eplerenone [35.5%]). Adrenalectomy was guided by lateralization at adrenal venous sampling in 33.5% of the overall cohort, and by imaging in all the other cases. Patients pretreated with MRA had longer duration of hypertension, higher prevalence of hypokalemia, and greater aldosterone concentrations than those not pretreated (n = 82). No differences in the rate of postsurgical hyperkalemia, hypoaldosteronism, renal function impairment, blood pressure changes, and biochemical outcomes were detected between groups in the immediate (\u226430 days) and short-term (\u226490 days) follow-up evaluations after surgery. At long-term follow-up (\u22656 months), patients pretreated with MRA exhibited better postsurgical biochemical outcomes (81.7% had complete biochemical response vs 57.1% of non-pretreated patients; P = .004). In the multivariable analysis, the use of MRA prior to adrenalectomy was independently associated with a successful postsurgical biochemical response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative MRA therapy can be safely introduced to control blood pressure and potassium levels in patients with PA awaiting surgery, without increasing the risk of postoperative hyperkalemia, hypoaldosteronism, renal impairment, or hypotension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf545","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:54:23Z","timestamp":1759492463000},"page":"e1153-e1163","source":"Crossref","is-referenced-by-count":6,"title":["Mineralocorticoid Receptor Antagonist Pre-Adrenalectomy in Primary Aldosteronism"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4985-1546","authenticated-orcid":false,"given":"Jessica","family":"Goi","sequence":"first","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario & Instituto de Investigaci\u00f3n Biom\u00e9dica Ram\u00f3n y Cajal (IRYCIS) , Madrid 28034 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Paja Fano","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, OSI Bilbao-Basurto, Hospital Universitario de Basurto, University of the Basque Country UPV\/EHU , Bilbao 48013 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Rizo Gellida","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario de Castell\u00f3n , Castell\u00f3n 12004 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marga","family":"Gonz\u00e1lez-Boillos","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario de Castell\u00f3n , Castell\u00f3n 12004 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mart\u00edn Rojas-Marcos","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario La Paz , Madrid 28046 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Caja Guayerbas","sequence":"additional","affiliation":[{"name":"Biochemistry Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid 28034 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Mar\u00eda","family":"Garc\u00eda Cano","sequence":"additional","affiliation":[{"name":"Biochemistry Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid 28034 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Gabriel","family":"Ruiz-Sanchez","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz , Madrid 28040 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Vicente","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario de Toledo , Toledo 45007 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"G\u00f3mez-Hoyos","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario de Valladolid, Institute for Health Research (IBIoVALL) , Valladolid 47003 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Guardiola","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Infanta Sof\u00eda , Madrid 28702 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Mar\u00eda","family":"Perdomo","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Cl\u00ednica Universidad de Navarra , Pamplona 31008 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Manj\u00f3n-Migu\u00e9lez","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital Universitario Central de Asturias & Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA) , Oviedo 33011 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngel","family":"Rebollo Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital 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,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Gonzalvo Diaz","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Complejo Hospitalario Universitario de Albacete , Albacete 02006 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-9508","authenticated-orcid":false,"given":"Cristina","family":"Lamas","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Complejo Hospitalario Universitario de Albacete , Albacete 02006 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Serrano","sequence":"additional","affiliation":[{"name":"Endocrinology & Nutrition Department, Hospital General Universitario de Alicante , Alicante 03010 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