Zhang J, Libianto R, Lee JC, et al. - Retrospective cohort study investigating if in patients undergoing unilateral adrenalectomy for the treatment of primary aldosteronism (PA), mineralocorticoid receptor antagonists (MRA) are associated with the incidence of postoperative hyperkalaemia in addition to perioperative blood pressure and potassium concentration.

• Of 96 patients with unilateral forms of PA, 73 (‘MRA’ group) received preoperative MRA while 23 patients (‘No-MRA’ group) did not.

• The ‘No-MRA’ group showed significantly higher prevalence of postoperative hyperkalaemia at 2–4 weeks after surgery, relative to the ‘MRA’ group (35% vs 11%).

• Findings revealed correlation of using MRA preoperatively with optimal perioperative blood pressure and normalized serum potassium in addition to a lower incidence of postoperative hyperkalaemia.

• Researchers recommend considering MRA as standard treatment for patients awaiting surgery for PA.