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Unmasking the Hidden Risks: How Adrenalectomy Impacts Kidney Function

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Kai Mendoza in Health & Wellness November 2025 • 4 min read.

"New research reveals the critical need for monitoring kidney health after adrenalectomy in primary aldosteronism patients, especially those over 55. Learn how to protect your kidney health."


Primary aldosteronism (PA) is a condition characterized by the autonomous overproduction of aldosterone, often due to an adrenal lesion. This hormonal imbalance leads to high blood pressure and can significantly impact kidney health. Adrenalectomy, the surgical removal of one or both adrenal glands, is a common treatment for PA, but its effects on kidney function require careful consideration.

Recent studies suggest that adrenalectomy can lead to a decline in kidney function in some patients with PA. Understanding the factors that contribute to this decline is essential for optimizing patient care and preventing long-term kidney damage. The initial hyperfiltration that may occur before surgery often masks the degree of kidney impairment.

This article delves into the findings of a recent study investigating the impact of adrenalectomy on kidney function. We'll explore the risk factors associated with kidney function decline after surgery, and what proactive steps can be taken to mitigate these risks, ensuring better long-term health outcomes.

Why Monitor Kidney Function After Adrenalectomy?

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A new study published in the International Journal of Urology (October 8, 2018) assessed the postoperative kidney function in 90 patients who underwent adrenalectomy for primary aldosteronism. The findings revealed that, on average, kidney function declined after the surgery. Specifically, the mean estimated glomerular filtration rate (eGFR), a measure of kidney function, decreased by 13.3% one month post-surgery (before: 72.9 mL/min/1.73 m², after: 64.9 mL/min/1.73 m², P < 0.0001). This highlights the importance of monitoring kidney function in these patients.

Several factors were identified as independent predictors of a ≥10% decline in eGFR. These include:

  • Older Age: Patients over 55 were more likely to experience a decline.
  • Preoperative Plasma Aldosterone Concentration (PAC): Higher PAC levels before surgery were associated with a greater risk of decline.
  • Preoperative Serum Potassium Level: Lower potassium levels before surgery also indicated a higher risk.
These findings indicate that older individuals with higher aldosterone levels and lower potassium levels prior to surgery may require closer monitoring and proactive management to prevent significant kidney function deterioration. This underscores the need for a personalized approach to patient care.

Protecting Your Kidney Health After Adrenalectomy

The study's findings underscore the importance of careful monitoring and management of kidney health in patients undergoing adrenalectomy for primary aldosteronism. By identifying and addressing risk factors such as older age, high preoperative aldosterone levels, and low potassium levels, healthcare professionals can help mitigate the risk of kidney function decline and improve long-term outcomes. If you're preparing for or recovering from adrenalectomy, proactive communication with your healthcare provider is essential. Regular kidney function tests, a balanced diet, and appropriate medical management can help preserve your kidney health.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/iju.13844, Alternate LINK

Title: Assessment Of Postoperative Renal Function After Adrenalectomy In Patients With Primary Aldosteronism

Subject: Urology

Journal: International Journal of Urology

Publisher: Wiley

Authors: Tadashi Onohara, Toshio Takagi, Kazuhiko Yoshida, Junpei Iizuka, Masayoshi Okumi, Tsunenori Kondo, Hideki Ishida, Kazunari Tanabe

Published: 2018-11-01

Everything You Need To Know

1

Why is it so important to monitor kidney function after adrenalectomy in patients with primary aldosteronism (PA)?

Adrenalectomy, the surgical removal of one or both adrenal glands, is often performed to treat primary aldosteronism (PA). PA is characterized by the autonomous overproduction of aldosterone, frequently caused by an adrenal lesion. While adrenalectomy can address the hormonal imbalance, it's essential to monitor kidney function because recent research indicates that kidney function can decline post-surgery. This decline is particularly concerning in individuals over 55, those with higher preoperative plasma aldosterone concentration (PAC), and those with lower preoperative serum potassium levels.

2

What were the key findings of the study published in the *International Journal of Urology* regarding kidney function following adrenalectomy?

The *International Journal of Urology* study revealed that kidney function, measured by estimated glomerular filtration rate (eGFR), declined by an average of 13.3% one month after adrenalectomy in primary aldosteronism patients. The eGFR went from 72.9 mL/min/1.73 m² before surgery to 64.9 mL/min/1.73 m² after. This decline highlights the necessity for vigilant monitoring to preserve kidney health in these patients. Individuals over 55 with elevated preoperative plasma aldosterone concentration (PAC) and diminished preoperative serum potassium level had the greatest decline.

3

What are the primary risk factors that contribute to kidney function decline after adrenalectomy for primary aldosteronism?

Several risk factors have been identified. These include older age (over 55), higher preoperative plasma aldosterone concentration (PAC), and lower preoperative serum potassium levels. These factors independently predict a decline in estimated glomerular filtration rate (eGFR) following adrenalectomy. Patients exhibiting these risk factors require more vigilant monitoring and potentially proactive interventions to mitigate the risk of kidney function deterioration.

4

What practical steps can individuals take to protect their kidney health after undergoing adrenalectomy?

To protect kidney health post-adrenalectomy, proactive communication with healthcare providers is crucial. Regular kidney function tests, a balanced diet, and appropriate medical management can help preserve kidney health. Addressing risk factors like high preoperative plasma aldosterone concentration (PAC) and low preoperative serum potassium levels can mitigate kidney function decline and improve long-term outcomes. Tailored monitoring and management strategies are essential.

5

What aspects of kidney health after adrenalectomy aren't fully addressed, and what further research could provide more insight?

While the research highlights the importance of monitoring kidney function in primary aldosteronism patients post-adrenalectomy, it doesn't delve into the specific mechanisms causing the decline in estimated glomerular filtration rate (eGFR). It also omits discussing potential interventions beyond diet and medical management, such as specific medications or lifestyle adjustments that could further protect kidney health. Further research may explore the correlation between the duration of primary aldosteronism before adrenalectomy and the extent of kidney function decline, as well as the impact of different surgical techniques on postoperative kidney outcomes.

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