Effects of Glucocorticoid Therapy on Renal Function in Patients With PA Complicated by CKD After Adrenalectomy: A Multicenter RCT
Starting soon · Phase 4
Conditions studied: Primary Aldosteronism Due to Adrenal Hyperplasia
In brief
This multicenter randomized controlled trial plans to enroll primary aldosteronism (PA) patients who meet the following criteria: confirmed unilateral dominant secretion by adrenal vein sampling (AVS), willingness to undergo surgery, and coexisting chronic kidney disease (CKD). Participants will be randomly assigned in a 1:1 ratio to one of two groups. To determine whether short-term postoperative hydrocortisone replacement therapy (intervention group) is superior to conventional management (surgery within 7 days after AVS, control group) in terms of reducing the decline in estimated glomerular filtration rate (eGFR) at 12 months after surgery.
Key facts
- Study ID
- NCT07558811
- Run by
- Ruijin Hospital
- People needed
- 90
- Starts
- 2026-04-22
- Expected to finish
- 2028-12-31
- Last updated by the study team
- 2026-04-30
Who can join
Age: 18 and older, up to 75. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Signed and dated informed consent form.
- Age 18-75 years, any gender.
- Confirmed diagnosis of primary aldosteronism (PA): positive PA screening test plus positive saline infusion test or captopril challenge test.
- Imaging findings indicating unilateral adrenal lesion, with adrenal vein sampling (AVS) confirming unilateral dominant secretion consistent with the lesion side, and planned unilateral adrenalectomy.
- Baseline eGFR 30-60 mL/min/1.73 m² OR positive proteinuria.
You may not qualify if…
- Use of hydrocortisone within 3 months prior to AVS.
- eGFR < 30 mL/min/1.73 m², or documented acute kidney injury (AKI) within the past 3 months.
- Overt cortisol-secreting tumor (clinical Cushing's syndrome) or requirement for long-term hormone replacement therapy.
- Severe proteinuria (24-hour urinary protein ≥ 3.5 g or ACR ≥ 300 mg/g).
- NYHA class III-IV heart failure, or acute coronary syndrome or stroke within the past 3 months.
- Severe allergy to hydrocortisone or history of serious adverse reactions to hydrocortisone.
- Pregnancy, lactation, or planned pregnancy in the near future.
- Active malignancy or life expectancy < 1 year.
- Inability to tolerate surgery.
- Inability to comply with follow-up as judged by the investigator, or any other condition deemed unsuitable for study participation.
Full record on ClinicalTrials.gov
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