Correlation between Plasma Aldosterone Concentrations and Simple Renal Cyst in Hypertensive Patients

BACKGROUND: Previous studies have linked primary aldosteronism to simple renal cysts (SRCs), but the relationship between plasma aldosterone concentration (PAC) and SRC remains unclear. This study aimed to investigate the association between PAC and SRC in hypertensive patients. METHODS: A total of 30,135 hypertensive patients who visited our hospital from January 2014 to December 2023 were included. Logistic regression analyses were conducted to explore the relationship between PAC and SRC, while restricted cubic splines (RCS) assessed the dose-response relationship. SRC were further categorized by size (≥2 cm) and number ≥2). Subgroup analyses were performed to evaluate PAC effects across different conditions. RESULTS: Multivariate logistic regression showed a positive association between PAC levels (per 5-ng/dL increase) and SRC (OR: 1.20, 95% CI: 1.17-1.23) after adjusting for confounders. Compared to the lowest PAC quartile (Q1), the Q2, Q3, and Q4 groups had progressively higher risks of SRC, with ORs of 1.03 (95% CI: 0.95-1.12), 1.25 (95% CI: 1.15-1.35), and 1.65 (95% CI: 1.52-1.78), respectively. Combining Q3 and Q4 (PAC ≥14.92) yielded an OR of 1.41 compared to Q1 and Q2 (<14.92). Similar trends were observed for SRC size ≥2 cm and number ≥2. RCS analysis confirmed a linear dose-response relationship between PAC and SRC risk. Subgroup and sensitivity analyses consistently supported these findings. CONCLUSIONS: Elevated PAC levels have been linked to an increased risk of SRC in hypertensive patients. Regulating PAC levels may help mitigate SRC formation; however, further prospective studies are required to confirm this causal relationship.