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U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism
  1. Min-Tsun Liao1,
  2. Che-Wei Liao1,
  3. Cheng-Hsuan Tsai2,
  4. Yi-Yao Chang3,
  5. Zheng-Wei Chen4,
  6. Chien-Ting Pan2,
  7. Lung-Chun Lin2,
  8. Vin-Cent Wu2,
  9. Shu-Fen Kuo2,
  10. Xue-Ming Wu5,
  11. Chi-Sheng Hung2,
  12. Yen-Hung Lin2
  13. the TAIPAI study group
  1. 1 Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
  2. 2 Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  3. 3 Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
  4. 4 Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou, Taiwan
  5. 5 Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan
  1. Correspondence to Dr Chi-Sheng Hung, Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; bitterendcv{at}; Dr Xue-Ming Wu, Internal Medicine, Taoyun General Hospital, Taoyuan, Taiwan; ad224413{at}


Estimated glomerular filtration rate (eGFR) is an important topic in patients with primary aldosteronism (PA). However, the relationship between left ventricular structure and eGFR is unclear. We conducted a prospective, observational, and cross-sectional study to analyze 168 patients with PA and 168 propensity score-matched patients with essential hypertension (EH) as the control group, matched by age, gender, and systolic blood pressure. In the patients with PA, the eGFR was not correlated with left ventricular mass index (LVMI; r=−0.065, p=0.404), while in the patients with EH, the eGFR was negatively correlated with LVMI (r=−0.309, p<0.001). To test whether eGFR had a non-linear relationship with LVMI among the patients with PA, we stratified the patients with PA according to the tertile of eGFR (low, medium, and high tertile). The medium tertile of patients had a significantly lower LVMI than those in the other two tertiles (LVMI: 143.5±41.6, 120.5±40.5, and 133.1±34.3 g/m2, from the lowest to highest tertile of eGFR; analysis of covariance p=0.032). The medium tertile of eGFR is associated with lowest LVMI. Patients with PA with high and low eGFR were associated with higher LVMI. The findings implied that the reasons for an increased LVMI in patients with PA may be different to those in patients with EH.

  • primary aldosteronism
  • estimated glomerular filtration rate
  • left ventricular hypertrophy
  • left ventricular mass index
  • hyperfiltration
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  • Contributors Conceptualization: Y-HL and C-SH. Methodology: M-TL and C-SH. Software: M-TL and C-SH. Validation: C-WL, C-HT, Y-YC, Z-WC, S-FK, and L-CL. Formal analysis: M-TL and C-SH. Investigation: M-TL and X-MW. Resources: Y-HL. Data curation: M-TL and Y-HL. Writing—original draft preparation: M-TL. Writing—review and editing: C-SH and Y-HL. Visualization: M-TL and C-TP. Supervision: V-CW and Y-HL. Project administration: Y-HL. Funding acquisition, Y-HL.

  • Funding This study was supported by Ta-Tung Kidney Foundation, National Taiwan University Hospital (NTUH 107-A141), Ministry of Science and Technology (MOST 106-2314-B-002-169-MY3), and Department of Health, Executive Yuan, R.O.C. (PTH10305, PTH10435, PTH10508, PTH10627, PTH10744).

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Institutional Review Board of National Taiwan University Hospital. The number is 200611031R.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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