{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:09:00Z","timestamp":1790352540157,"version":"4.1.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In primary aldosteronism (PA), renal impairment has been identified as an important comorbidity. Excess cortisol production also may lead to renal damage; thus, concomitant mild autonomous cortisol secretion (MACS) may predispose PA patients to renal disorders. However, there is limited evidence to support this claim. Therefore, this study aimed to determine whether the concurrence of MACS and PA increases the risk of renal complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study is a retrospective cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 1310 patients with PA were stratified into two groups according to 1 mg dexamethasone suppression test (DST) results (cut-off post-DST serum cortisol 1.8 \u00b5g\/dL): MACS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009340) and non-MACS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009970). The prevalence of renal complications was compared between the group. We also performed multiple logistic regression analysis to determine factors that increase the risk for renal complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of lowered estimated glomerular filtration rate (eGFR) and proteinuria was nearly twice higher in the MACS group than in the non-MACS group. Not only plasma aldosterone concentration (PAC) but also the presence of MACS was selected as independent factors that were associated with the two renal outcomes. The risk of lower eGFR or proteinuria in patients who had MACS and higher levels PAC was several folds higher than in those who had an absence of MACS and lower levels of PAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MACS is an independent risk factor for renal complications in patients with PA, and MACS concomitant with higher aldosterone secretion in PA patients causes an increase in the risk of developing renal complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/eje-21-1131","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T13:39:43Z","timestamp":1649165983000},"page":"645-655","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":33,"title":["Primary aldosteronism with mild autonomous cortisol secretion increases renal complication risk"],"prefix":"10.1093","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-8645","authenticated-orcid":true,"given":"Takuyuki","family":"Katabami","sequence":"first","affiliation":[{"name":"Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5041-6344","authenticated-orcid":true,"given":"Ren","family":"Matsuba","sequence":"additional","affiliation":[{"name":"Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension, and Endocrinology, Nihon University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-3121","authenticated-orcid":true,"given":"Tomoko","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isao","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism, and Nephrology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Department of Medical Education, National Defense Medical College, Saitama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamasa","family":"Ichijo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Tsuiki","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Sapporo City General Hospital, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakatsu","family":"Sone","sequence":"additional","affiliation":[{"name":"Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan"},{"name":"Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuya","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Tokyo, Japan"},{"name":"Department of Diabetes and Endocrinology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Showa General Hospital, Tokyo, 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