Table 3.
Baseline factors associated with clinical and biochemical outcomes after adrenalectomy for unilateral primary aldosteronism
| Clinical outcome
|
Biochemical outcome
|
|||||||
|---|---|---|---|---|---|---|---|---|
| Unadjusted analysis
|
Adjusted analysis
|
Unadjusted analysis
|
Adjusted analysis
|
|||||
| Odds ratio (95% CI) | p value | Odds ratio (95% CI) | p value | Odds ratio (95% CI) | p value | Odds ratio (95% CI) | p value | |
|
Complete success versus partial plus absent success
| ||||||||
| Age (per year) | 0.94 (0.92–0.95) | <0.001 | 0.95 (0.93–0.98) | <0.001 | 1.00 (0.97–1.03) | 0.911 | 0.98 (0.94–1.02) | 0.324 |
| Lowest serum potassium ion concentration (per 1 mmol/L) | 1.64 (1.22–2.21) | 0.001 | 1.43 (0.95–2.15) | 0.086 | 1.56 (0.86–2.88) | 0.147 | 1.43 (0.69–2.95) | 0.339 |
| Antihypertension medication (per 1 unit of defined daily dose) | 0.68 (0.62–0.75) | <0.001 | 0.80 (0.70–0.90) | <0.001 | 0.96 (0.85–1.09) | 0.480 | 0.87 (0.74–1.02) | 0.094 |
| eGFR (per 1 mL/min per 1.73 m2) | 1.02 (1.01–1.03) | <0.001 | 1.01 (1.00–1.02) | 0.083 | 0.99 (0.98–1.01) | 0.374 | 0.99 (0.97–1.01) | 0.169 |
| Systolic blood pressure (per 1 mm Hg) | 0.98 (0.98–0.99) | <0.001 | 0.99 (0.98–1.01) | 0.287 | 1.02 (1.00–1.04) | 0.025 | 1.03 (1.01–1.05) | 0.013 |
| BMI (per 1 kg/m2) | 0.90 (0.87–0.93) | <0.001 | 0.98 (0.94–1.03) | 0.380 | 1.02 (0.96–1.08) | 0.617 | 0.95 (0.88–1.02) | 0.149 |
| Sex (reference: female) | 4.37 (3.16–6.07) | <0.001 | 2.25 (1.40–3.62) | 0.001 | 1.22 (0.65–2.33) | 0.538 | 0.99 (0.42–2.32) | 0.977 |
| Left ventricular hypertrophy (reference: not detected) | 2.53 (1.71–3.76) | <0.001 | 1.61 (1.01–2.59) | 0.047 | 0.75 (0.34–1.64) | 0.470 | 0.70 (0.30–1.62) | 0.403 |
|
Complete plus partial success versus absent success | ||||||||
| Age (per year) | 0.96 (0.94–0.98) | <0.001 | 0.95 (0.92–0.98) | 0.004 | 1.02 (0.97–1.06) | 0.431 | 1.03 (0.96–1.11) | 0.523 |
| Lowest serum potassium ion concentration (per 1 mmol/L) | 1.53 (1.03–2.29) | 0.036 | 1.18 (0.70–2.00) | 0.540 | 0.92 (0.35–2.51) | 0.872 | 0.90 (0.26–3.12) | 0.866 |
| Antihypertension medication (per 1 unit of defined daily dose) | 1.08 (0.99–1.19) | 0.086 | 1.27 (1.08–1.50) | 0.005 | 0.88 (0.75–1.07) | 0.175 | 0.79 (0.61–1.01) | 0.062 |
| eGFR (per 1 mL/min per 1.73 m2) | 1.01 (1.00–1.03) | 0.018 | 1.01 (1.00–1.02) | 0.368 | 1.01 (0.98–1.04) | 0.553 | 1.01 (0.97–1.04) | 0.716 |
| Systolic blood pressure (per 1 mm Hg) | 1.01 (1.00–1.03) | 0.005 | 1.03 (1.01–1.04) | 0.003 | 1.01 (0.99–1.04) | 0.352 | 1.03 (0.99–1.07) | 0.140 |
| BMI (per 1 kg/m2) | 0.95 (0.91–0.98) | 0.004 | 0.90 (0.85–0.96) | 0.001 | 0.93 (0.85–1.01) | 0.071 | 0.89 (0.79–1.00) | 0.043 |
| Sex (reference: female) | 3.06 (1.94–4.97) | <0.001 | 2.89 (1.49–5.59) | 0.002 | 1.75 (0.63–5.62) | 0.302 | 1.91 (0.41–8.99) | 0.413 |
| Left ventricular hypertrophy (reference: not detected) | 1.14 (0.70–1.88) | 0.601 | 1.39 (0.76–2.54) | 0.290 | 0.76 (0.19–2.90) | 0.682 | 0.54 (0.12–2.37) | 0.416 |
|
Complete success versus absent success | ||||||||
| Age (per year) | 0.93 (0.90–0.95) | <0.001 | 0.92 (0.88–0.96) | <0.001 | 1.02 (0.97–1.06) | 0.441 | 1.02 (0.95–1.10) | 0.549 |
| Lowest serum potassium ion concentration (per 1 mmol/L) | 1.94 (1.26–3.03) | 0.003 | 1.24 (0.64–2.39) | 0.519 | 0.95 (0.36–2.58) | 0.917 | 0.98 (0.28–3.47) | 0.969 |
| Antihypertension medication (per 1 unit of defined daily dose) | 0.83 (0.74–0.94) | 0.002 | 1.05 (0.86–1.28) | 0.609 | 0.88 (0.75–1.07) | 0.177 | 0.78 (0.61–1.00) | 0.054 |
| eGFR (per 1 mL/min per 1.73 m2) | 1.03 (1.02–1.05) | <0.001 | 1.01 (0.99–1.03) | 0.177 | 1.01 (0.98–1.04) | 0.583 | 1.00 (0.97–1.04) | 0.819 |
| Systolic blood pressure (per 1 mm Hg) | 1.00 (0.99–1.01) | 0.767 | 1.02 (1.00–1.04) | 0.082 | 1.01 (0.99–1.04) | 0.319 | 1.03 (0.99–1.07) | 0.137 |
| BMI (per 1 kg/m2) | 0.91 (0.87–0.95) | <0.001 | 0.91 (0.85–0.97) | 0.004 | 0.93 (0.85–1.01) | 0.081 | 0.88 (0.79–0.99) | 0.039 |
| Sex (reference: female) | 6.54 (3.98–11.04) | <0.001 | 4.48 (2.10–9.60) | <0.001 | 1.75 (0.63–5.62) | 0.303 | 1.90 (0.40–8.97) | 0.418 |
| Left ventricular hypertrophy (reference: not detected) | 2.02 (1.17–3.51) | 0.013 | 1.89 (0.90–3.99) | 0.093 | 0.75 (0.18–2.87) | 0.670 | 0.54 (0.12–2.34) | 0.405 |
Logistic regression analyses were done at the patient level to identify factors associated with clinical and biochemical outcome. Eight covariates were entered into each model and their unadjusted odds ratios (ORs) are shown with the corresponding ORs adjusted for the confounding effects of the other covariates in the model. For most results, an OR greater than 1 indicates an increased likelihood of clinical or biochemical outcome and an OR less than 1 a decreased likelihood; the exception is for potassium ion concentration, which was analysed for lowest values, therefore in this case an OR greater than 1 indicates a decreased likelihood and an OR less than 1 an increased likelihood. The final adjusted models included data from 414 patients with complete data for all eight variables (clinical outcome: complete [n=158], partial [n=192], absent [n=64]; biochemical outcome: complete [n=387], partial [n=18], absent [n=9]). eGFR=estimated glomerular filtration rate.