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dc.contributor.author
Arregger, Alejandro Luis
dc.contributor.author
Cardoso, Estela M. del Luján
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Zucchini, Alfredo Enrique
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Aguirre, Elvira C.
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Elbert, Alicia
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Contreras, Liliana Noemí
dc.date.available
2017-12-11T21:17:15Z
dc.date.issued
2014-03
dc.identifier.citation
Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Zucchini, Alfredo Enrique; Aguirre, Elvira C.; Elbert, Alicia; et al.; Adrenocotrical function in hypotensive patients with end stage renal disease; Elsevier; Steroids; 84; 3-2014; 57-63
dc.identifier.issn
0039-128X
dc.identifier.uri
http://hdl.handle.net/11336/30211
dc.description.abstract
Background: Sustained hypotension among patients with end stage renal disease on dialysis (ESRDh) varies from 5.0% to 12.0%. Despite their role in the regulation of blood pressure (BP) corticoadrenal hormones have been poorly investigated.
Objectives: This study aims to detect adrenal insufficiency in ESRDh and follow their clinical outcome.
Methods: Fifty ESRDh and 30 healthy volunteers were studied. In all cases basal blood and saliva were obtained. Synthetic ACTH (25 μg) was injected intramuscularly and at 30 min saliva was collected. Circulating ACTH, renin, cortisol and aldosterone were measured and steroids were also assessed in saliva by immunoassay.
Results: Fifteen ESRDh achieved steroid responses not different than healthy volunteers; four had primary adrenal insufficiency; six had secondary adrenal insufficiency; nine had selective hypoaldosteronism and sixteen secondary hyperaldosteronism. The years on dialysis did not differ among subgroups. ROC analysis defined the following cut-offs for basal cortisol to predict adrenal insufficiency: in serum ⩽232.0 nM (sensitivity (S) 100.0% and specificity (E) 90.0%); in saliva ⩽4.4 nM (100.0% S and E). Basal aldosterone cut-off values to predict hyperaldosteronism were: in serum >500.0 pM and saliva >60.0 pM (100.0% S and E, for both). For the prediction of hypoaldosteronism the basal serum aldosterone was ⩽260.0 pM (100% S; 53% E) and in saliva it was ⩽20.1 pM (100% S; 58.5% E). Three patients with primary adrenal insufficiency and six with secondary adrenal insufficiency improved general clinical condition and normalized BP on steroids. One patient died before initiation of steroid therapy.
Conclusion: Adrenal function should be assessed in ESRDh in order to unmask adrenal insufficient states.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Elsevier
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.subject
Adrenal Function
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Hypotension
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End Stage Renal Disease
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Chronic Renal Failure
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Acth-Stimulation Test
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Chronic Renal Failure
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Salivary Cortisol
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Salivary Aldosterone
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Medicina Critica y de Emergencia
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Medicina Clínica
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Adrenocotrical function in hypotensive patients with end stage renal disease
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2017-12-11T16:45:35Z
dc.journal.volume
84
dc.journal.pagination
57-63
dc.journal.pais
Países Bajos
dc.journal.ciudad
Ámsterdam
dc.description.fil
Fil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
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Fil: Cardoso, Estela M. del Luján. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
dc.description.fil
Fil: Zucchini, Alfredo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
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Fil: Aguirre, Elvira C.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
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Fil: Elbert, Alicia. Centro de estudios Renales e Hipertensión Arterial; Argentina
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Fil: Contreras, Liliana Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
dc.journal.title
Steroids
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039128X14000622
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1016/j.steroids.2014.03.008
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