KCNJ5 -Negative Primary Aldosteronism: Histopathology and Surgical Outcomes.
Nonclassical adrenal histopathology linked to lower complete clinical success after adrenalectomy
KCNJ5 -Negative Primary Aldosteronism: Histopathology and Surgical Outcomes.
Unilateral primary aldosteronism (uPA) is the most common surgically curable secondary hypertension.
We investigated whether histopathologic subtypes defined by the HISTALDO (Histopathology of Primary Aldosteronism) consensus are associated with postoperative outcomes in KCNJ5 -negative uPA.
We analyzed 171 KCNJ5 -negative uPA patients from the Taiwan Primary Aldosteronism Investigation registry who underwent adrenalectomy.
nonclassical histopathology cut the odds of complete surgical cure
The cohort (mean age, 55.0±11.3 years; 53.8% women) comprised 90 (52.6%) patients with classical histopathology and 81 (47.4%) with nonclassical features.
Complete clinical success was achieved in 40.9% of patients at 12 months.
Patients with classical histopathology had significantly higher complete clinical success (50%) than those with nonclassical histopathology (30.9%; P =0.01).
Nearly half of KCNJ5 -negative uPA cases exhibit nonclassical adrenal histopathology, which is associated with significantly lower complete clinical success rates.
These findings underscore the prognostic value of histopathologic classification in KCNJ5 -negative uPA and support integrating histology and genetics to improve patient management.