Adrenocotrical function in hypotensive patients with end stage renal disease

Autores
Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Zucchini, Alfredo Enrique; Aguirre, Elvira C.; Elbert, Alicia; Contreras, Liliana Noemí
Año de publicación
2014
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
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.
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
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
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
Fil: Aguirre, Elvira C.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Elbert, Alicia. Centro de estudios Renales e Hipertensión Arterial; Argentina
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
Materia
Adrenal Function
Hypotension
End Stage Renal Disease
Chronic Renal Failure
Acth-Stimulation Test
Chronic Renal Failure
Salivary Cortisol
Salivary Aldosterone
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/30211
Acceder
id CONICETDig_65b814476a5ed5ff82f0ed15927d89f8
oai_identifier_str oai:ri.conicet.gov.ar:11336/30211
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Adrenocotrical function in hypotensive patients with end stage renal diseaseArregger, Alejandro LuisCardoso, Estela M. del LujánZucchini, Alfredo EnriqueAguirre, Elvira C.Elbert, AliciaContreras, Liliana NoemíAdrenal FunctionHypotensionEnd Stage Renal DiseaseChronic Renal FailureActh-Stimulation TestChronic Renal FailureSalivary CortisolSalivary Aldosteronehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: 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.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; ArgentinaFil: 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; ArgentinaFil: 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; ArgentinaFil: Aguirre, Elvira C.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Elbert, Alicia. Centro de estudios Renales e Hipertensión Arterial; ArgentinaFil: 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; ArgentinaElsevier2014-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/30211Arregger, 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; 57-630039-128XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039128X14000622info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2014.03.008info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:57:57Zoai:ri.conicet.gov.ar:11336/30211instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:57:57.36CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Adrenocotrical function in hypotensive patients with end stage renal disease
title Adrenocotrical function in hypotensive patients with end stage renal disease
spellingShingle Adrenocotrical function in hypotensive patients with end stage renal disease
Arregger, Alejandro Luis
Adrenal Function
Hypotension
End Stage Renal Disease
Chronic Renal Failure
Acth-Stimulation Test
Chronic Renal Failure
Salivary Cortisol
Salivary Aldosterone
title_short Adrenocotrical function in hypotensive patients with end stage renal disease
title_full Adrenocotrical function in hypotensive patients with end stage renal disease
title_fullStr Adrenocotrical function in hypotensive patients with end stage renal disease
title_full_unstemmed Adrenocotrical function in hypotensive patients with end stage renal disease
title_sort Adrenocotrical function in hypotensive patients with end stage renal disease
dc.creator.none.fl_str_mv Arregger, Alejandro Luis
Cardoso, Estela M. del Luján
Zucchini, Alfredo Enrique
Aguirre, Elvira C.
Elbert, Alicia
Contreras, Liliana Noemí
author Arregger, Alejandro Luis
author_facet Arregger, Alejandro Luis
Cardoso, Estela M. del Luján
Zucchini, Alfredo Enrique
Aguirre, Elvira C.
Elbert, Alicia
Contreras, Liliana Noemí
author_role author
author2 Cardoso, Estela M. del Luján
Zucchini, Alfredo Enrique
Aguirre, Elvira C.
Elbert, Alicia
Contreras, Liliana Noemí
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Adrenal Function
Hypotension
End Stage Renal Disease
Chronic Renal Failure
Acth-Stimulation Test
Chronic Renal Failure
Salivary Cortisol
Salivary Aldosterone
topic Adrenal Function
Hypotension
End Stage Renal Disease
Chronic Renal Failure
Acth-Stimulation Test
Chronic Renal Failure
Salivary Cortisol
Salivary Aldosterone
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv 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.
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
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
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
Fil: Aguirre, Elvira C.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Elbert, Alicia. Centro de estudios Renales e Hipertensión Arterial; Argentina
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
description 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.
publishDate 2014
dc.date.none.fl_str_mv 2014-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/30211
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
0039-128X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/30211
identifier_str_mv 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
0039-128X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039128X14000622
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2014.03.008
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
application/pdf
application/pdf
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dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.13397

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