Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure

Autores
Contreras, Liliana Noemí; Arregger, Alejandro Luis; Tumilasci, Omar Rene; Persi, Gabriel; Zucchini, Alfredo Enrique; Cardoso, Estela M. del Luján
Año de publicación
2006
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Summary OBJECTIVE Hypotension increases morbidity and mortality in patients with chronic renal failure .However, adrenocortical insufficiency has not been deeply investigated as possible physiopathologic mechanism of this haemodynamic dysfunction.  The aim of this study was to explore adrenocortical function through the assessment of salivary steroids after conventional ACTH-dose stimulation (rapid ACTH test) in   patients with chronic renal failure (CRF) and sustained hypotension. DESIGN Salivary samples for cortisol and aldosterone measurements were obtained in each subject before and after stimulation with ACTH (250 mg) intramuscularly injected. SUBJECTS Twenty CRF patients with sustained hypotension and twenty four healthy subjects (controls). METHODS  Salivary flow rate was calculated in each subject. Salivary cortisol and salivary aldosterone concentrations were measured at baseline and 30 minutes after ACTH intramuscular injection. RESULTS Adequate salivary function was demonstrated in each patient. Primary and secondary adrenal insufficiencies were diagnosed in two and three CRF patients, respectively. Selective hypoaldosteronism and hyperaldosteronism were found in four and  six CRF patients respectively, while normal  adrenocortical function was demonstrated in  five cases. CONCLUSIONS These data show that nine out of twenty hypotensive CRF patients had adrenocortical insufficiency (either primary or secondary) while six exhibited hyperaldosteronism as an appropriate physiological response to volume depletion. Salivary steroid measurements after rapid ACTH test offer the opportunity to less invasively investigate adrenal status in these high risk patients in which anemia and involvement of vascular access limit dynamic blood testing. Basal salivary aldosterone samples were helpful to distinguish states of aldosterone excess .
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
Fil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Zucchini, Alfredo Enrique. 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
Materia
ACTH test
salivary steroids
adrenal insufficiency
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:11336/110048
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/110048
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failureContreras, Liliana NoemíArregger, Alejandro LuisTumilasci, Omar RenePersi, GabrielZucchini, Alfredo EnriqueCardoso, Estela M. del LujánACTH testsalivary steroidsadrenal insufficiencyhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Summary OBJECTIVE Hypotension increases morbidity and mortality in patients with chronic renal failure .However, adrenocortical insufficiency has not been deeply investigated as possible physiopathologic mechanism of this haemodynamic dysfunction.  The aim of this study was to explore adrenocortical function through the assessment of salivary steroids after conventional ACTH-dose stimulation (rapid ACTH test) in   patients with chronic renal failure (CRF) and sustained hypotension. DESIGN Salivary samples for cortisol and aldosterone measurements were obtained in each subject before and after stimulation with ACTH (250 mg) intramuscularly injected. SUBJECTS Twenty CRF patients with sustained hypotension and twenty four healthy subjects (controls). METHODS  Salivary flow rate was calculated in each subject. Salivary cortisol and salivary aldosterone concentrations were measured at baseline and 30 minutes after ACTH intramuscular injection. RESULTS Adequate salivary function was demonstrated in each patient. Primary and secondary adrenal insufficiencies were diagnosed in two and three CRF patients, respectively. Selective hypoaldosteronism and hyperaldosteronism were found in four and  six CRF patients respectively, while normal  adrenocortical function was demonstrated in  five cases. CONCLUSIONS These data show that nine out of twenty hypotensive CRF patients had adrenocortical insufficiency (either primary or secondary) while six exhibited hyperaldosteronism as an appropriate physiological response to volume depletion. Salivary steroid measurements after rapid ACTH test offer the opportunity to less invasively investigate adrenal status in these high risk patients in which anemia and involvement of vascular access limit dynamic blood testing. Basal salivary aldosterone samples were helpful to distinguish states of aldosterone excess .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; ArgentinaFil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Zucchini, Alfredo Enrique. 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; ArgentinaLippincott Williams2006-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/110048Contreras, Liliana Noemí; Arregger, Alejandro Luis; Tumilasci, Omar Rene; Persi, Gabriel; Zucchini, Alfredo Enrique; et al.; Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure; Lippincott Williams; Endocrinologist; 16; 1; 1-2006; 30-351051-2144CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1097/01.ten.0000194248.85361.bfinfo:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/theendocrinologist/Abstract/2006/01000/Salivary_Steroids_in_Response_to_ACTH__A_Less.9.aspxinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:55:38Zoai:ri.conicet.gov.ar:11336/110048instacron: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 09:55:38.945CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
title Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
spellingShingle Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
Contreras, Liliana Noemí
ACTH test
salivary steroids
adrenal insufficiency
title_short Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
title_full Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
title_fullStr Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
title_full_unstemmed Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
title_sort Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure
dc.creator.none.fl_str_mv Contreras, Liliana Noemí
Arregger, Alejandro Luis
Tumilasci, Omar Rene
Persi, Gabriel
Zucchini, Alfredo Enrique
Cardoso, Estela M. del Luján
author Contreras, Liliana Noemí
author_facet Contreras, Liliana Noemí
Arregger, Alejandro Luis
Tumilasci, Omar Rene
Persi, Gabriel
Zucchini, Alfredo Enrique
Cardoso, Estela M. del Luján
author_role author
author2 Arregger, Alejandro Luis
Tumilasci, Omar Rene
Persi, Gabriel
Zucchini, Alfredo Enrique
Cardoso, Estela M. del Luján
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv ACTH test
salivary steroids
adrenal insufficiency
topic ACTH test
salivary steroids
adrenal insufficiency
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Summary OBJECTIVE Hypotension increases morbidity and mortality in patients with chronic renal failure .However, adrenocortical insufficiency has not been deeply investigated as possible physiopathologic mechanism of this haemodynamic dysfunction.  The aim of this study was to explore adrenocortical function through the assessment of salivary steroids after conventional ACTH-dose stimulation (rapid ACTH test) in   patients with chronic renal failure (CRF) and sustained hypotension. DESIGN Salivary samples for cortisol and aldosterone measurements were obtained in each subject before and after stimulation with ACTH (250 mg) intramuscularly injected. SUBJECTS Twenty CRF patients with sustained hypotension and twenty four healthy subjects (controls). METHODS  Salivary flow rate was calculated in each subject. Salivary cortisol and salivary aldosterone concentrations were measured at baseline and 30 minutes after ACTH intramuscular injection. RESULTS Adequate salivary function was demonstrated in each patient. Primary and secondary adrenal insufficiencies were diagnosed in two and three CRF patients, respectively. Selective hypoaldosteronism and hyperaldosteronism were found in four and  six CRF patients respectively, while normal  adrenocortical function was demonstrated in  five cases. CONCLUSIONS These data show that nine out of twenty hypotensive CRF patients had adrenocortical insufficiency (either primary or secondary) while six exhibited hyperaldosteronism as an appropriate physiological response to volume depletion. Salivary steroid measurements after rapid ACTH test offer the opportunity to less invasively investigate adrenal status in these high risk patients in which anemia and involvement of vascular access limit dynamic blood testing. Basal salivary aldosterone samples were helpful to distinguish states of aldosterone excess .
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
Fil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Tumilasci, Omar Rene. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Zucchini, Alfredo Enrique. 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
description Summary OBJECTIVE Hypotension increases morbidity and mortality in patients with chronic renal failure .However, adrenocortical insufficiency has not been deeply investigated as possible physiopathologic mechanism of this haemodynamic dysfunction.  The aim of this study was to explore adrenocortical function through the assessment of salivary steroids after conventional ACTH-dose stimulation (rapid ACTH test) in   patients with chronic renal failure (CRF) and sustained hypotension. DESIGN Salivary samples for cortisol and aldosterone measurements were obtained in each subject before and after stimulation with ACTH (250 mg) intramuscularly injected. SUBJECTS Twenty CRF patients with sustained hypotension and twenty four healthy subjects (controls). METHODS  Salivary flow rate was calculated in each subject. Salivary cortisol and salivary aldosterone concentrations were measured at baseline and 30 minutes after ACTH intramuscular injection. RESULTS Adequate salivary function was demonstrated in each patient. Primary and secondary adrenal insufficiencies were diagnosed in two and three CRF patients, respectively. Selective hypoaldosteronism and hyperaldosteronism were found in four and  six CRF patients respectively, while normal  adrenocortical function was demonstrated in  five cases. CONCLUSIONS These data show that nine out of twenty hypotensive CRF patients had adrenocortical insufficiency (either primary or secondary) while six exhibited hyperaldosteronism as an appropriate physiological response to volume depletion. Salivary steroid measurements after rapid ACTH test offer the opportunity to less invasively investigate adrenal status in these high risk patients in which anemia and involvement of vascular access limit dynamic blood testing. Basal salivary aldosterone samples were helpful to distinguish states of aldosterone excess .
publishDate 2006
dc.date.none.fl_str_mv 2006-01
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/11336/110048
Contreras, Liliana Noemí; Arregger, Alejandro Luis; Tumilasci, Omar Rene; Persi, Gabriel; Zucchini, Alfredo Enrique; et al.; Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure; Lippincott Williams; Endocrinologist; 16; 1; 1-2006; 30-35
1051-2144
CONICET Digital
CONICET
url http://hdl.handle.net/11336/110048
identifier_str_mv Contreras, Liliana Noemí; Arregger, Alejandro Luis; Tumilasci, Omar Rene; Persi, Gabriel; Zucchini, Alfredo Enrique; et al.; Salivary steroids in response to ACTH: a less invasive approach to assess adrenal function in hypotensive patients with chronic renal failure; Lippincott Williams; Endocrinologist; 16; 1; 1-2006; 30-35
1051-2144
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1097/01.ten.0000194248.85361.bf
info:eu-repo/semantics/altIdentifier/url/https://journals.lww.com/theendocrinologist/Abstract/2006/01000/Salivary_Steroids_in_Response_to_ACTH__A_Less.9.aspx
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
application/pdf
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dc.publisher.none.fl_str_mv Lippincott Williams
publisher.none.fl_str_mv Lippincott Williams
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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