Academic Journal
Clinical phenotypes and disease outcomes of patients with systemic lupus erythematosus meeting indication for primary aldosteronism testing.
| Τίτλος: | Clinical phenotypes and disease outcomes of patients with systemic lupus erythematosus meeting indication for primary aldosteronism testing. |
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| Συγγραφείς: | Wong M; Department of Medicine, Monash University, Clayton, VIC, Australia., Akram M; Centre for Endocrinology and Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia., Kent JR; Department of Nephrology, Monash Health, Clayton, VIC, Australia., Fuller PJ; Centre for Endocrinology and Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.; Department of Endocrinology, Monash Health, Clayton, VIC, Australia., Hoi AY; Department of Rheumatology, Monash Health, Clayton, VIC, Australia.; Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia., Yang J; Department of Medicine, Monash University, Clayton, VIC, Australia.; Centre for Endocrinology and Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.; Department of Endocrinology, Monash Health, Clayton, VIC, Australia., Vincent FB; Centre for Inflammatory Diseases, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia. |
| Πηγή: | Lupus [Lupus] 2026 Oct; Vol. 35 (12), pp. 1308-1319. Date of Electronic Publication: 2026 Jul 31. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: SAGE Publications Country of Publication: England NLM ID: 9204265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0962 (Electronic) Linking ISSN: 09612033 NLM ISO Abbreviation: Lupus Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : SAGE Publications Original Publication: Houndmills, Basingstoke, Hampshire, UK : Scientific & Medical Division, Macmillan Press Ltd., c1991- |
| Ιατρικοί όροι (MeSH): | Hyperaldosteronism*/diagnosis , Hyperaldosteronism*/complications , Hyperaldosteronism*/epidemiology , Lupus Erythematosus, Systemic*/complications , Lupus Erythematosus, Systemic*/physiopathology , Hypertension*/etiology , Hypertension*/epidemiology , Hypertension*/diagnosis, Humans ; Female ; Retrospective Studies ; Phenotype ; Middle Aged ; Male ; Adult ; Blood Pressure ; Prevalence |
| Περίληψη: | BackgroundHypertension is prevalent and contributes significantly to cardiovascular risk in patients with systemic lupus erythematosus (SLE). Primary aldosteronism (PA), the most common endocrine cause of hypertension, confers higher cardiovascular risk than essential hypertension and has been linked to autoimmune diseases including SLE. While the prevalence of PA in SLE is unknown, a third of patients in a tertiary lupus clinic have been demonstrated to have clinical indications for PA testing.ObjectivesTo compare SLE phenotypes and outcomes in patients attending the clinic with and without indications for PA testing.MethodsIn this retrospective study, hypertension was defined as blood pressure ≥140/90 on two clinic visits, or a documented diagnosis of hypertension. Baseline demographic and SLE disease characteristics were compared between patients with and without an indication for PA testing as determined according to the 2016 Endocrine Society guidelines, before multivariable regression analyses assessed for associations between having an indication for PA testing with disease phenotypes and outcomes specifically within the subset of patients with hypertension.ResultsOf 322 patients with SLE, 95 patients (30%) had at least one indication for PA testing. These patients were older, had longer SLE disease duration, higher body mass index, higher blood pressure, and more baseline organ damage compared to those without an indication for PA testing. Over the period of clinic attendance (median 6.8 years), these patients had greater accrual of organ damage, higher flare rates, and more frequent proteinuria. Within the subset of hypertensive patients, indications for PA testing were independently associated with reduced baseline renal function (adjusted OR 3.29, 95% CI 1.30-9.47; p = 0.017), higher baseline organ damage (adjusted OR 1.94, 95% CI 1.03-3.73; p = 0.043), and higher prevalence of flare throughout the study period (adjusted OR 2.86, 95% CI 1.04-8.60; p = 0.049) in multivariable modelling.ConclusionSLE patients with an indication for PA testing exhibit a phenotype characterised by impaired renal function, increased organ damage and higher prevalence of flare. Further research is needed to prospectively assess whether the increased burden is attributable to PA, other causes of hypertension, or the severe hypertension. |
| Competing Interests: | Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AH has received a research grant from AstraZeneca, consulting fees from EUSA Pharma (UK), GSK and UCB Australia and speaker fees/honoraria from AbbVie, Eli Lilly, Janssen, Limbic, Moose Republic and Novartis. JY is supported by funding from the National Health and Medical Research Council (Emerging Leadership 1, APP2041474). The Hudson Institute of Medical Research is supported by the Victorian Government’s Operational Infrastructure Scheme. FBV was supported by funding from National Health and Medical Research Council (Emerging Leadership 1, grant 1196112), receives funding from Arthritis Australia & Arthritis and Osteoporosis Western Australia (Grant 26-AA/AWA-F), and has received support from the Rebecca L Cooper Medical Research Foundation and Arthritis Australia. FBV has received support from Janssen-Cilag, AstraZeneca and CSL for projects, in-kind support from Olink, SomaLogic and Sengenics, and support from Pfizer, Lupus Research Alliance, and SomaLogic for conference or meeting sponsorship. |
| Contributed Indexing: | Keywords: aldosterone; cardiovascular; hypertension; primary aldosteronism (PA); renin; systemic lupus erythematosus (SLE) |
| Entry Date(s): | Date Created: 20260731 Date Completed: 20260915 Latest Revision: 20260915 |
| Update Code: | 20260915 |
| PubMed Central ID: | PMC13569909 |
| DOI: | 10.1177/09612033261473968 |
| PMID: | 42533601 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1477-0962 |
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| DOI: | 10.1177/09612033261473968 |