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Рецепт. 2018; : 303-312

Первичный гиперальдостеронизм: определение, классификация, диагностика, лечение

Тишковский С. В., Никонова Л. В.

Аннотация

Актуальность изучения первичного гиперальдостеронизма обусловлена трудностью диагностики данной патологии. Причиной гиперальдостеронизма может служить множество факторов. Существует определенный контингент пациентов, нуждающихся в обследовании на предмет гиперальдостеронизма с использованием специальных диагностических тестов. Только четкое понимание специалистом этиопатогенеза этой патологии, ее клинических проявлений, правильная трактовка диагностических результатов позволяет установить диагноз, в последующем назначить адекватное лечение и существенно снизить морбидность и смертность пациентов данного профиля, улучшить качество их жизни.

Список литературы

1. Bel’cevich D. (2008) Pervichnyj giperal’dosteronizm. Klinicheskie rekomendacii [Primary hyperaldosteronism. Clinical recommendations]. Endocrine Surgery, no 2, pp. 6-20.

2. Beloborodov V., Vysockij V. (2011) Jeffektivnost’ differencial’noj diagnostiki novoobrazovanija nadpochechnikov [The effectiveness of the differential diagnosis of tumors of the adrenal glands]. Siberian Medical Journal (Irkutsk), vol. 100, no 1, pp. 59-61.

3. Calhoun D.A. (2007) Is there an unrecognized epidemic of primary aldosteronism? (Pro).

4. Hypertension, vol. 50, no 3, pp. 447-453. doi: 10.1161/HYPERTENSIONAHA.106.086116.

5. Chihladze N. (1992) Pervichnyj giperal’dosteronizm [Primary hyperaldosteronism]. Vrach, no 1, pp. 9-13.

6. Dedov I., Melnichenko G. (2016) Jendokrinologija. Nacional’noe rukovodstvo [Endocrinology. National leadership]. Moscow: GEOTAR-Media.

7. Funder J.W. (2013) Primary aldosteronism and low-renin hypertension: a continuum? Nephrol Dial Transplant, vol. 28, no 7, pp. 1625-1627. doi: 10.1093/ndt/gft052.

8. Funder J.W., Carey R.M., Mantero F., Murad M.H., Reincke M., Shibata H. (2016) The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J Clin Endocrinol Metab., vol. 101, no 5, pp. 1889-1916. doi: 10.1210/jc.2015-4061.

9. Goh B.K., Tan Y.H., Chang K.T., Eng P.H., Yip S.K., Cheng C.W. (2007) Primary hyperaldosteronism secondary to unilateral adrenal hyperplasia: an unusual cause of surgically correctable hypertension. A review of 30 cases. World J. Surg., vol. 31, no 1, pp. 72-79. doi: 10.1007/s00268- 005-0594-8.

10. Gomez-Sanchez E.P. (2010) The mammalian mineralocorticoid receptor: tying down a promiscuous receptor. Exp Physiol., vol. 95, no 1, pp. 13-18. doi: 10.1113/expphysiol.2008.045914.

11. Hannemann A., Bidlingmaier M., Friedrich N., Manolopoulou J., Spyroglou A., Völzke H. (2012) Screening for primary aldosteronism in hypertensive subjects: results from two German epidemiological studies. Eur J Endocrinol, vol. 167, no 1, pp. 7-15. doi: 10.1530/EJE-11-1013.

12. Icard P., Goudet P., Charpenay C., Andreassian B., Carnaille B., Chapuis Y. (2001) Adrenocortical carcinomas: surgical trends and results of a 253 patient series from the French Association of Endocrine Surgeons study group. World J. Surg., vol. 25, no 7, pp. 891-897.

13. Kalinin A., Majstrenko N. (2000) Hirurgija nadpochechnikov [Adrenal surgery]. Moscow: Medicina.

14. Kaljagin A., Beloborodov V., Maksikova T. (2017) Simptomaticheskaja arterial’naja gipertenzija na fone pervichnogo giperal’dosteronizma [Symptomatic arterial hypertension associated with primary hyperaldosteronism]. Arterial Hypertension, vol. 23, no 3, pp. 224-230.

15. Kozulin M., Privalov Ju., Aleksina E., Kulikov L., Poljakova G. (2009) Kliniko-morfologicheskaja harakteristika pervichnogo giperal’dosteronizma [Clinical and morphological character of primary hyperaldosteronism]. Siberian Medical Journal (Irkutsk), vol. 86, no 3, pp. 56-59.

16. Kudlasevich S., Rusalenko M., Rozhko A., Mohort T. (2009) Simptomaticheskie gipertenzii pri pervichnom giperal’dosteronizme [Symptomatic hypertensions at primary hiperaldosteronism]. Problemy zdorov’ja i jekologii, vol. 1, no 19, pp. 20-24.

17. Mihina M., Platonova N., Molashenko N., Troshina E. (2015) Diagnostika i lechenie pervichnogo giperal’dosteronizma [The diagnostic and treatment of primary hyperaldosteronism]. Treatment and prevention, vol. 2, no 14, pp. 72-78.

18. Miyaji Y., Kawabata Y., Joki H., Seki S., Mori K., Kamide T. (2016) Primary aldosteronism in patients with acute stroke: prevalence and diagnosis during initial hospitalization. BMC Neurol, vol. 16, pp. 177. doi: 10.1186/s12883-016-0701-5.

19. Mohort T., Zabarovskaja Z., Shepel’kevich A. (2015) Klinicheskaja jendokrinologija: uchebnik

20. [Clinical endocrinology]. Minsk: Vyshjejshaja shkola.

21. Molashenko N., Troshina E. (2012) Pervichnyj idiopaticheskij giperal’dosteronizm v klinicheskoj praktike [Primary idiopathic hyperaldosteronism in clinical practice]. Obesity and metabolism, vol. 9, no 4, pp. 3-9.

22. Mulatero P., Stowasser M., Loh K.C., Fardella C.E., Gordon R.D., Mosso L. (2004) Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab., vol. 89, no 3, pp. 1045-1050. doi: 10.1210/jc.2003-031337.

23. Pan’kiv V. (2011) Giperal’dosteronizm: opredelenie, jetiologija, klassifikacija, klinicheskie priznaki i sindromy, diagnostika, lechenie. International endocrinology journal, vol. 7, no 39, pp. 122-129.

24. Pascoe L., Curnow K.M., Slutsker L., Connell J.M., Speiser P.W., New M.I., White P.C. (1992) Glucocorticoid suppressible hyperaldosteronism results from hybrid genes created by unequal crossovers between CYP11B1 and CYP11B2. Proc. Natl. Acad. Sci. USA, vol. 89, no 17, pp. 8327- 8331.

25. Piaditis G., Markou A., Papanastasiou L., Androulakis I.I., Kaltsas G. (2015) Progress in aldosteronism: a review of the prevalence of primary aldosteronism in pre-hypertension and hypertension. Eur J Endocrinol., vol. 172, no 5, pp. 191-203. doi: 10.1530/EJE-14-0537.

26. Rebrova D., Vorokhobina N., Baranov V., Velikanova L. (2017) Sposob differencial’noj diagnostiki osnovnyh form pervichnogo giperal’dosteronizma s primeneniem vysokojeffektivnoj zhidkostnoj hromatografii [The method of differential diagnosis of the main forms of primary hyperaldosteronism by high performance liquid chromatohraphy]. Arterial Hypertension, vol. 23, no 3, pp. 212-223.

27. Rossi G.P., Auchus R., Brown M., Lenders J., Naruse M., Plouin P.F. (2014) An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension, vol. 63, no 1, pp. 151-160. doi: 10.1161/HYPERTENSIONAHA.113.02097.

28. Rossi G.P., Barisa M., Allolio B., Auchus R.J., Amar L., Cohen D. (2012) The adrenal vein sampling international study (AVIS) for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab., vol. 97, no 5, pp. 1606-1614. doi: 10.1210/jc.2011-2830.

29. Satoh F., Abe T., Tanemoto M., Nakamura M., Abe M., Uruno A. (2007) Localization of aldosterone- producing adrenocortical adenomas: significance of adrenal venous sampling. Hypertens Res., vol. 30, no 11, pp. 1083-1095. doi: 10.1291/hypres.30.1083.

30. Stowasser M. (2015) Update in primary aldosteronism J. Clin. Endocrinol. Metab., vol. 100, no 1, pp. 1-10. doi: 10.1210/jc.2014-3663.

31. Vonend O., Ockenfels N., Gao X., Allolio B., Lang K., Mai K. (2011) Adrenal venous sampling. Evaluation of the German Conn’s registry. Hypertension, vol. 57, no 5, pp. 990-995. doi: 10.1161/ HYPERTENSIONAHA.110.168484.

32. Woolsey S., Brown B., Ralls B., Friedrichs M., Stults B. (2017) Diagnosing hypertension in primary care clinics according to current guidelines. J Am Board Fam Med., vol. 30, no 2, pp. 170-177. doi: 10.3122/jabfm.2017.02.160111.

33. Young W.F. (2009) Primary aldosteronism - one picture is not worth a thousand words. Ann Intern Med., vol. 151, no 5, pp. 357-358.

34. Yukina M., Troshina E., Bel’tsevich D., Platonova N. (2016) Vtorichnaja (jendokrinnaja) arterial’naja gipertenzija: lekcija dlja vrachej [Secondary (endocrine) hypertension: lecture]. Almanac of Clinical Medicine, vol. 44, no 4, pp. 501-512.

Recipe. 2018; : 303-312

Primary hyperaldosteronism: definition, classification, diagnostics, treatment

Tishkovskiy S. ., Nikonova L. .

Abstract

The relevance of the study of primary hyperaldosteronism is due to the difficulty of the diagnosis of this disease. It was found that the cause of hyperaldosteronism can be many factors. There is a particular group of patients requiring screening for hyperaldosteronism using special diagnostic tests. Only a clear understanding of etiopathogenesis of this pathology and its clinical manifestations by the specialist, the correct interpretation of diagnostic results make it possible to establish the diagnosis, to administer the appropriate treatment and significantly reduce the morbidity and mortality of patients of this profile and improve their quality of life.
References

1. Bel’cevich D. (2008) Pervichnyj giperal’dosteronizm. Klinicheskie rekomendacii [Primary hyperaldosteronism. Clinical recommendations]. Endocrine Surgery, no 2, pp. 6-20.

2. Beloborodov V., Vysockij V. (2011) Jeffektivnost’ differencial’noj diagnostiki novoobrazovanija nadpochechnikov [The effectiveness of the differential diagnosis of tumors of the adrenal glands]. Siberian Medical Journal (Irkutsk), vol. 100, no 1, pp. 59-61.

3. Calhoun D.A. (2007) Is there an unrecognized epidemic of primary aldosteronism? (Pro).

4. Hypertension, vol. 50, no 3, pp. 447-453. doi: 10.1161/HYPERTENSIONAHA.106.086116.

5. Chihladze N. (1992) Pervichnyj giperal’dosteronizm [Primary hyperaldosteronism]. Vrach, no 1, pp. 9-13.

6. Dedov I., Melnichenko G. (2016) Jendokrinologija. Nacional’noe rukovodstvo [Endocrinology. National leadership]. Moscow: GEOTAR-Media.

7. Funder J.W. (2013) Primary aldosteronism and low-renin hypertension: a continuum? Nephrol Dial Transplant, vol. 28, no 7, pp. 1625-1627. doi: 10.1093/ndt/gft052.

8. Funder J.W., Carey R.M., Mantero F., Murad M.H., Reincke M., Shibata H. (2016) The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline. J Clin Endocrinol Metab., vol. 101, no 5, pp. 1889-1916. doi: 10.1210/jc.2015-4061.

9. Goh B.K., Tan Y.H., Chang K.T., Eng P.H., Yip S.K., Cheng C.W. (2007) Primary hyperaldosteronism secondary to unilateral adrenal hyperplasia: an unusual cause of surgically correctable hypertension. A review of 30 cases. World J. Surg., vol. 31, no 1, pp. 72-79. doi: 10.1007/s00268- 005-0594-8.

10. Gomez-Sanchez E.P. (2010) The mammalian mineralocorticoid receptor: tying down a promiscuous receptor. Exp Physiol., vol. 95, no 1, pp. 13-18. doi: 10.1113/expphysiol.2008.045914.

11. Hannemann A., Bidlingmaier M., Friedrich N., Manolopoulou J., Spyroglou A., Völzke H. (2012) Screening for primary aldosteronism in hypertensive subjects: results from two German epidemiological studies. Eur J Endocrinol, vol. 167, no 1, pp. 7-15. doi: 10.1530/EJE-11-1013.

12. Icard P., Goudet P., Charpenay C., Andreassian B., Carnaille B., Chapuis Y. (2001) Adrenocortical carcinomas: surgical trends and results of a 253 patient series from the French Association of Endocrine Surgeons study group. World J. Surg., vol. 25, no 7, pp. 891-897.

13. Kalinin A., Majstrenko N. (2000) Hirurgija nadpochechnikov [Adrenal surgery]. Moscow: Medicina.

14. Kaljagin A., Beloborodov V., Maksikova T. (2017) Simptomaticheskaja arterial’naja gipertenzija na fone pervichnogo giperal’dosteronizma [Symptomatic arterial hypertension associated with primary hyperaldosteronism]. Arterial Hypertension, vol. 23, no 3, pp. 224-230.

15. Kozulin M., Privalov Ju., Aleksina E., Kulikov L., Poljakova G. (2009) Kliniko-morfologicheskaja harakteristika pervichnogo giperal’dosteronizma [Clinical and morphological character of primary hyperaldosteronism]. Siberian Medical Journal (Irkutsk), vol. 86, no 3, pp. 56-59.

16. Kudlasevich S., Rusalenko M., Rozhko A., Mohort T. (2009) Simptomaticheskie gipertenzii pri pervichnom giperal’dosteronizme [Symptomatic hypertensions at primary hiperaldosteronism]. Problemy zdorov’ja i jekologii, vol. 1, no 19, pp. 20-24.

17. Mihina M., Platonova N., Molashenko N., Troshina E. (2015) Diagnostika i lechenie pervichnogo giperal’dosteronizma [The diagnostic and treatment of primary hyperaldosteronism]. Treatment and prevention, vol. 2, no 14, pp. 72-78.

18. Miyaji Y., Kawabata Y., Joki H., Seki S., Mori K., Kamide T. (2016) Primary aldosteronism in patients with acute stroke: prevalence and diagnosis during initial hospitalization. BMC Neurol, vol. 16, pp. 177. doi: 10.1186/s12883-016-0701-5.

19. Mohort T., Zabarovskaja Z., Shepel’kevich A. (2015) Klinicheskaja jendokrinologija: uchebnik

20. [Clinical endocrinology]. Minsk: Vyshjejshaja shkola.

21. Molashenko N., Troshina E. (2012) Pervichnyj idiopaticheskij giperal’dosteronizm v klinicheskoj praktike [Primary idiopathic hyperaldosteronism in clinical practice]. Obesity and metabolism, vol. 9, no 4, pp. 3-9.

22. Mulatero P., Stowasser M., Loh K.C., Fardella C.E., Gordon R.D., Mosso L. (2004) Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab., vol. 89, no 3, pp. 1045-1050. doi: 10.1210/jc.2003-031337.

23. Pan’kiv V. (2011) Giperal’dosteronizm: opredelenie, jetiologija, klassifikacija, klinicheskie priznaki i sindromy, diagnostika, lechenie. International endocrinology journal, vol. 7, no 39, pp. 122-129.

24. Pascoe L., Curnow K.M., Slutsker L., Connell J.M., Speiser P.W., New M.I., White P.C. (1992) Glucocorticoid suppressible hyperaldosteronism results from hybrid genes created by unequal crossovers between CYP11B1 and CYP11B2. Proc. Natl. Acad. Sci. USA, vol. 89, no 17, pp. 8327- 8331.

25. Piaditis G., Markou A., Papanastasiou L., Androulakis I.I., Kaltsas G. (2015) Progress in aldosteronism: a review of the prevalence of primary aldosteronism in pre-hypertension and hypertension. Eur J Endocrinol., vol. 172, no 5, pp. 191-203. doi: 10.1530/EJE-14-0537.

26. Rebrova D., Vorokhobina N., Baranov V., Velikanova L. (2017) Sposob differencial’noj diagnostiki osnovnyh form pervichnogo giperal’dosteronizma s primeneniem vysokojeffektivnoj zhidkostnoj hromatografii [The method of differential diagnosis of the main forms of primary hyperaldosteronism by high performance liquid chromatohraphy]. Arterial Hypertension, vol. 23, no 3, pp. 212-223.

27. Rossi G.P., Auchus R., Brown M., Lenders J., Naruse M., Plouin P.F. (2014) An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension, vol. 63, no 1, pp. 151-160. doi: 10.1161/HYPERTENSIONAHA.113.02097.

28. Rossi G.P., Barisa M., Allolio B., Auchus R.J., Amar L., Cohen D. (2012) The adrenal vein sampling international study (AVIS) for identifying the major subtypes of primary aldosteronism. J Clin Endocrinol Metab., vol. 97, no 5, pp. 1606-1614. doi: 10.1210/jc.2011-2830.

29. Satoh F., Abe T., Tanemoto M., Nakamura M., Abe M., Uruno A. (2007) Localization of aldosterone- producing adrenocortical adenomas: significance of adrenal venous sampling. Hypertens Res., vol. 30, no 11, pp. 1083-1095. doi: 10.1291/hypres.30.1083.

30. Stowasser M. (2015) Update in primary aldosteronism J. Clin. Endocrinol. Metab., vol. 100, no 1, pp. 1-10. doi: 10.1210/jc.2014-3663.

31. Vonend O., Ockenfels N., Gao X., Allolio B., Lang K., Mai K. (2011) Adrenal venous sampling. Evaluation of the German Conn’s registry. Hypertension, vol. 57, no 5, pp. 990-995. doi: 10.1161/ HYPERTENSIONAHA.110.168484.

32. Woolsey S., Brown B., Ralls B., Friedrichs M., Stults B. (2017) Diagnosing hypertension in primary care clinics according to current guidelines. J Am Board Fam Med., vol. 30, no 2, pp. 170-177. doi: 10.3122/jabfm.2017.02.160111.

33. Young W.F. (2009) Primary aldosteronism - one picture is not worth a thousand words. Ann Intern Med., vol. 151, no 5, pp. 357-358.

34. Yukina M., Troshina E., Bel’tsevich D., Platonova N. (2016) Vtorichnaja (jendokrinnaja) arterial’naja gipertenzija: lekcija dlja vrachej [Secondary (endocrine) hypertension: lecture]. Almanac of Clinical Medicine, vol. 44, no 4, pp. 501-512.