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Tissue K+ in Primary Hyperaldosteronism

Not Applicable
Recruiting
Conditions
Primary Hyperaldosteronism
Electrolyte Disturbance
Interventions
Procedure: Surgical Treatment of Hyperaldosteronism
Drug: Drug treatment of Hyperaldosteronism
Registration Number
NCT04251780
Lead Sponsor
University of Erlangen-Nürnberg Medical School
Brief Summary

Recent human studies found tissue sodium storage in patients with hyperaldosteronism that could be detected non-invasively by 23Na-MRI. Tissue sodium accumulation could be mobilized upon treatment of hyperaldosteronism. Besides, former animal studies applying chemical electrolyte analysis indicate that this aldosterone induced sodium storage might be accompanied by intracellular potassium loss. Wether such an intracellular tissue Potassium loss occurs in vivo in patients with hyperaldosteronism and if this deficiency can be corrected by treatment is unclear. The investigators will employ 39K-MR Imaging at 7Tesla to further assess this hypothesis.

Detailed Description

Patients diagnosed with primary hyperaldosteronism will be investigated using 23Na-MRI and 39K-MRI at 7 Tesla to assess tissue sodium and potassium content. Measurements will be conducted before treatment of hyperaldosteronism and three months after adrenal surgery or medical treatment (Spironolactone or Eplerenone). Furthermore, blood pressure, body water distribution (by bioimpedance spectroscopy), serum electrolytes as well as monocyte function will be assessed.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Primary Hyperaldosteronism diagnosed according to the endocrinological guidelines (J Clin Endocrinology & Metabolism, May 2016)
Exclusion Criteria
  • Chronic kidney disease stage 3b and below (estimated GFR <30 ml/min according to CKD-EPI)
  • Acute kidney injury
  • Severe congestive heart failure (NYHA III and IV)
  • Liver Cirrhosis (Child B and C)
  • Pregnancy
  • Contraindications for MRI measurements: cardiac Pacemaker, claustrophobia, etc.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Hyperaldosteronism treatmentSurgical Treatment of HyperaldosteronismPatients with Hyperaldosteronism will either be treated by adrenalectomy (adrenal adenoma) or receive medical treatment (Spironolactone/Eplerenone; bilateral hyperplasia) as indicated by the Endocrinological Guideline (J Clin Endocrinology \& Metabolism, May 2016). Before and after intervention tissue sodium and tissue potassium amount will be assessed by MRI.
Hyperaldosteronism treatmentDrug treatment of HyperaldosteronismPatients with Hyperaldosteronism will either be treated by adrenalectomy (adrenal adenoma) or receive medical treatment (Spironolactone/Eplerenone; bilateral hyperplasia) as indicated by the Endocrinological Guideline (J Clin Endocrinology \& Metabolism, May 2016). Before and after intervention tissue sodium and tissue potassium amount will be assessed by MRI.
Primary Outcome Measures
NameTimeMethod
Tissue potassium content3-6 months after intervention

Change in tissue potassium content measured by MRI before and after treatment of hyperaldosteronism

Secondary Outcome Measures
NameTimeMethod
Blood pressure3-6 months after intervention

Change in blood pressure (systolic/diastolic/mean) before and after treatment of hyperaldosteronism

Tissue sodium content3-6 months after intervention

Change in tissue sodium content measured by MRI before and after treatment of hyperaldosteronism

Trial Locations

Locations (2)

Nephrology Department, University Hospital Erlangen

🇩🇪

Erlangen, Bavaria, Germany

Radiology Department, University Hospital Erlangen

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Erlangen, Bavaria, Germany

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