Abstract P212: A Meta Analysis of Somatic KCNJ5 Mutations in 1636 Primary Aldosteronism Patients
Background: We meta-analysed the available studies reporting on KCNJ5 mutations in Aldosterone Producing Adenoma (APA) to determine the clinical characteristics of APA patients with a mutation of the KCNJ5 gene.
Methods: We applied the PICO strategy using predefined terms (Population: primary aldosteronism patients with aldosterone producing adenoma; Intervention: adrenalectomy, sequencing for KCNJ5 mutations; Control: APA without KCNJ5 mutations; Outcome: clinical and pathological correlates of KCNJ5 mutations) to extract relevant studies from the PubMed, Scopus, Web of Science e Cochrane databases until January 2015. To allow for independent replication of the results, we elected to use the commercially available software.
Results and Conclusions: By this PICO strategy we could identify 13 studies involving a total of 1636 patients (age 49 years ± 4; 55% females). The overall prevalence of KCNJ5 mutations was 43%; it was lower frequency (p<0.003) in European, USA and Australian studies (35%) than in Japanese and Chinese studies (63%), and correlated (r=0.70, p=0.008) with the mean daily urinary sodium excretion. The meta-analysis comparison of wild-type and KCNJ5 mutated patients demonstrated that the latter were younger (45±3 vs 52±5 years), had higher plasma aldosterone levels (42±8 vs 33±8 ng/dl), bigger tumors (16.1±6.4 vs 14.9±7.4 mm) and were more females (67% vs 44%) (p<0.05 for all). At variance, no significant effect of KCNJ5 mutations on systolic and diastolic blood pressure, and on serum potassium could be found.
Therefore, the meta-analysis of a large dataset comprising all studies available thus far showed that features associated with the presence of KCNJ5 mutations in PA due to APA entail young age, female gender, bigger tumor size and more prominent hyperaldosteronism.
Author Disclosures: G. Rossi: None. L. Lenzini: None. G. Rossitto: None. G. Maiolino: None. C. Letizia: None. J. Funder: None.
- © 2015 by American Heart Association, Inc.