1. Use of hydrocortisone within 3 months prior to AVS.

2. eGFR \< 30 mL/min/1.73 m², or documented acute kidney injury (AKI) within the past 3 months.

3. Overt cortisol-secreting tumor (clinical Cushing's syndrome) or requirement for long-term hormone replacement therapy.

4. Severe proteinuria (24-hour urinary protein ≥ 3.5 g or ACR ≥ 300 mg/g).

5. NYHA class III-IV heart failure, or acute coronary syndrome or stroke within the past 3 months.

6. Severe allergy to hydrocortisone or history of serious adverse reactions to hydrocortisone.

7. Pregnancy, lactation, or planned pregnancy in the near future.

8. Active malignancy or life expectancy \< 1 year.

9. Inability to tolerate surgery.

10. Inability to comply with follow-up as judged by the investigator, or any other condition deemed unsuitable for study participation.

Effects of Glucocorticoid Therapy on Renal Function in Patients With PA Complicated by CKD After Adrenalectomy: A Multicenter RCT