The functional state of the renin-aldosterone and pituitary-adrenal systems in patients after surgical treatment for aldosteroma

Objective: The assessment of the functional state of the renin-aldosterone and pituitary-adrenal systems after surgical treatment of patients with aldosteroma to optimize the tactics of postoperative management. Methods. In 22 patients with aldosterone-producing adenoma, the clinical manifestation, objective laboratory and instrumental data in the preoperative and early postoperative periods were analyzed. Assessment of glucocorticoid and mineralocorticoid hormone levels was carried out by immunoassay and high-performance liquid chromatography (HPLC). The results of the pre- and postoperative periods were compared among themselves and with the control group (27 healthy individuals). Results. Decreased activity of cytochrome P450 3A4 and 11fi-hydroxysteroid dehydrogenase type 2 enzymes in the preoperative and early postoperative periods, increased postoperative aldosterone/renin ratio compared to the control group, positive correlations of вв-hydroxycortisol with systolic blood pressure after surgery and 18-O-corticosterone with aldosterone, the serum corticosterone/ 11-dehydrocorticosterone ratio and blood pressure a month after the surgery - all of these are biomarkers of persistent postoperative arterial hypertension in patients with aldosteronoma. Conclusion. Impaired cortisol and corticosterone metabolism and increased serum aldosterone precursor levels in the preoperative and early postoperative periods, according to HPLC, are biomarkers for persistent arterial hypertension after surgery in patients with aldosteromas.

aldosterone-producing adenoma, arterial hypertension, postoperative period, high-performance liquid chromatography