Diagnostic value of salivary cortisol in end stage renal disease

Autores
Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Tumilasci, Omar Rene; Contreras, Liliana Noemí
Año de publicación
2008
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objectives: Salivary cortisol has been proposed a surrogate marker for free serum cortisol measurements. The aim of this study was to ascertain the diagnostic value of basal and stimulated salivary cortisol for the detection of adrenal insufficiency (AI) in hypotensive end stage renal disease (ESRD) patients. Basal salivary cortisol and basal total serum cortisol were studied in order to determine the accuracy of both biomarkers in predicting AI. Patients and methods: Twenty-nine ESRD patients with sustained hypotension were investigated for possible AI. Salivary cortisol was assessed at baseline and 30 min after 25 μg ACTH i.m. (LDTs). The dosage of salivary aldosterone was performed in salivary cortisol hypo-responders. Basal blood samples were drawn for steroids, renin and ACTH measurements. Results: A clear separation between patients with normal and impaired adrenal function was obtained through salivary cortisol levels at 30 min after ACTH. AI was detected in six cases (21%) through impaired salivary cortisol responses; stimulated salivary aldosterone helped to differentiate primary (n = 3) from secondary AI (n = 3). ROC curves showed that cutoff values for basal SAF ≤4.4 nM and serum cortisol ≤232.0 nM suggest AI (sensitivities: 93% and 69%; specificities: 86.4% and 91%, respectively). Conclusions: We conclude that ACTH stimulated SAF is an accurate biomarker for the diagnosis of AI in hypotensive ESRD patients. Neither basal salivary cortisol nor serum cortisol showed 100% sensitivities for the detection of AI.
Fil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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
Fil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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 Medicina. Instituto de Investigaciones Médicas; Argentina
Materia
salivary cortisol
renal disease
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/104670
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/104670
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Diagnostic value of salivary cortisol in end stage renal diseaseArregger, Alejandro LuisCardoso, Estela M. del LujánTumilasci, Omar ReneContreras, Liliana Noemísalivary cortisolrenal diseasehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objectives: Salivary cortisol has been proposed a surrogate marker for free serum cortisol measurements. The aim of this study was to ascertain the diagnostic value of basal and stimulated salivary cortisol for the detection of adrenal insufficiency (AI) in hypotensive end stage renal disease (ESRD) patients. Basal salivary cortisol and basal total serum cortisol were studied in order to determine the accuracy of both biomarkers in predicting AI. Patients and methods: Twenty-nine ESRD patients with sustained hypotension were investigated for possible AI. Salivary cortisol was assessed at baseline and 30 min after 25 μg ACTH i.m. (LDTs). The dosage of salivary aldosterone was performed in salivary cortisol hypo-responders. Basal blood samples were drawn for steroids, renin and ACTH measurements. Results: A clear separation between patients with normal and impaired adrenal function was obtained through salivary cortisol levels at 30 min after ACTH. AI was detected in six cases (21%) through impaired salivary cortisol responses; stimulated salivary aldosterone helped to differentiate primary (n = 3) from secondary AI (n = 3). ROC curves showed that cutoff values for basal SAF ≤4.4 nM and serum cortisol ≤232.0 nM suggest AI (sensitivities: 93% and 69%; specificities: 86.4% and 91%, respectively). Conclusions: We conclude that ACTH stimulated SAF is an accurate biomarker for the diagnosis of AI in hypotensive ESRD patients. Neither basal salivary cortisol nor serum cortisol showed 100% sensitivities for the detection of AI.Fil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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; ArgentinaFil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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 Medicina. Instituto de Investigaciones Médicas; ArgentinaElsevier Science Inc2008-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/104670Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Tumilasci, Omar Rene; Contreras, Liliana Noemí; Diagnostic value of salivary cortisol in end stage renal disease; Elsevier Science Inc; Steroids; 73; 1; 1-2008; 77-820039-128XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/abs/pii/S0039128X07001602info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2007.09.001info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:49:08Zoai:ri.conicet.gov.ar:11336/104670instacron: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 09:49:08.705CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Diagnostic value of salivary cortisol in end stage renal disease
title Diagnostic value of salivary cortisol in end stage renal disease
spellingShingle Diagnostic value of salivary cortisol in end stage renal disease
Arregger, Alejandro Luis
salivary cortisol
renal disease
title_short Diagnostic value of salivary cortisol in end stage renal disease
title_full Diagnostic value of salivary cortisol in end stage renal disease
title_fullStr Diagnostic value of salivary cortisol in end stage renal disease
title_full_unstemmed Diagnostic value of salivary cortisol in end stage renal disease
title_sort Diagnostic value of salivary cortisol in end stage renal disease
dc.creator.none.fl_str_mv Arregger, Alejandro Luis
Cardoso, Estela M. del Luján
Tumilasci, Omar Rene
Contreras, Liliana Noemí
author Arregger, Alejandro Luis
author_facet Arregger, Alejandro Luis
Cardoso, Estela M. del Luján
Tumilasci, Omar Rene
Contreras, Liliana Noemí
author_role author
author2 Cardoso, Estela M. del Luján
Tumilasci, Omar Rene
Contreras, Liliana Noemí
author2_role author
author
author
dc.subject.none.fl_str_mv salivary cortisol
renal disease
topic salivary cortisol
renal disease
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objectives: Salivary cortisol has been proposed a surrogate marker for free serum cortisol measurements. The aim of this study was to ascertain the diagnostic value of basal and stimulated salivary cortisol for the detection of adrenal insufficiency (AI) in hypotensive end stage renal disease (ESRD) patients. Basal salivary cortisol and basal total serum cortisol were studied in order to determine the accuracy of both biomarkers in predicting AI. Patients and methods: Twenty-nine ESRD patients with sustained hypotension were investigated for possible AI. Salivary cortisol was assessed at baseline and 30 min after 25 μg ACTH i.m. (LDTs). The dosage of salivary aldosterone was performed in salivary cortisol hypo-responders. Basal blood samples were drawn for steroids, renin and ACTH measurements. Results: A clear separation between patients with normal and impaired adrenal function was obtained through salivary cortisol levels at 30 min after ACTH. AI was detected in six cases (21%) through impaired salivary cortisol responses; stimulated salivary aldosterone helped to differentiate primary (n = 3) from secondary AI (n = 3). ROC curves showed that cutoff values for basal SAF ≤4.4 nM and serum cortisol ≤232.0 nM suggest AI (sensitivities: 93% and 69%; specificities: 86.4% and 91%, respectively). Conclusions: We conclude that ACTH stimulated SAF is an accurate biomarker for the diagnosis of AI in hypotensive ESRD patients. Neither basal salivary cortisol nor serum cortisol showed 100% sensitivities for the detection of AI.
Fil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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
Fil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; 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 Medicina. Instituto de Investigaciones Médicas; Argentina
description Objectives: Salivary cortisol has been proposed a surrogate marker for free serum cortisol measurements. The aim of this study was to ascertain the diagnostic value of basal and stimulated salivary cortisol for the detection of adrenal insufficiency (AI) in hypotensive end stage renal disease (ESRD) patients. Basal salivary cortisol and basal total serum cortisol were studied in order to determine the accuracy of both biomarkers in predicting AI. Patients and methods: Twenty-nine ESRD patients with sustained hypotension were investigated for possible AI. Salivary cortisol was assessed at baseline and 30 min after 25 μg ACTH i.m. (LDTs). The dosage of salivary aldosterone was performed in salivary cortisol hypo-responders. Basal blood samples were drawn for steroids, renin and ACTH measurements. Results: A clear separation between patients with normal and impaired adrenal function was obtained through salivary cortisol levels at 30 min after ACTH. AI was detected in six cases (21%) through impaired salivary cortisol responses; stimulated salivary aldosterone helped to differentiate primary (n = 3) from secondary AI (n = 3). ROC curves showed that cutoff values for basal SAF ≤4.4 nM and serum cortisol ≤232.0 nM suggest AI (sensitivities: 93% and 69%; specificities: 86.4% and 91%, respectively). Conclusions: We conclude that ACTH stimulated SAF is an accurate biomarker for the diagnosis of AI in hypotensive ESRD patients. Neither basal salivary cortisol nor serum cortisol showed 100% sensitivities for the detection of AI.
publishDate 2008
dc.date.none.fl_str_mv 2008-01
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/11336/104670
Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Tumilasci, Omar Rene; Contreras, Liliana Noemí; Diagnostic value of salivary cortisol in end stage renal disease; Elsevier Science Inc; Steroids; 73; 1; 1-2008; 77-82
0039-128X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/104670
identifier_str_mv Arregger, Alejandro Luis; Cardoso, Estela M. del Luján; Tumilasci, Omar Rene; Contreras, Liliana Noemí; Diagnostic value of salivary cortisol in end stage renal disease; Elsevier Science Inc; Steroids; 73; 1; 1-2008; 77-82
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/https://www.sciencedirect.com/science/article/abs/pii/S0039128X07001602
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2007.09.001
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Science Inc
publisher.none.fl_str_mv Elsevier Science Inc
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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