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Primary aldosteronism is underdiagnosed in patients with chronic kidney disease (CKD), perhaps because clinicians assume that resistant hypertension in these patients is attributable solely to the CKD (J Nephrol 2022; 35:1667). In this retrospective study, researchers describe outcomes of treatment in 239 hypertensive patients (mean age, 57) with CKD who received diagnoses of primary aldosteronism in U.S. academic specialty clinics. At baseline, estimated glomerular filtration rate was between 20 and 60 mL/minute/1.73 m2 in most patients (mean, 45 mL/minute).
On adrenal vein sampling, two thirds of patients lateralized and underwent adrenalectomy; the others were treated with spironolactone or eplerenone. During median follow-up of 4.5 years…