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Titolo:
THE IMPACT OF LONG-TERM HEMODIALYSIS ON PITUITARY-ADRENOCORTICAL FUNCTION
Autore:
VIGNA L; BUCCIANTI G; ORSATTI A; CRESSERI D; BIANCHI ML; CREMAGNANI L; CANTALAMESSA L;
Indirizzi:
UNIV MILAN,OSPED MAGGIORE POLICLIN,IRCCS,IST MED INTERNA MALATTIE INFETT & IMMUNOPATOL I-20122 MILAN ITALY UNIV MILAN,OSPED MAGGIORE POLICLIN,IRCCS,IST MED INTERNA MALATTIE INFETT & IMMUNOPATOL I-20122 MILAN ITALY
Titolo Testata:
Renal failure
fascicolo: 5, volume: 17, anno: 1995,
pagine: 629 - 637
SICI:
0886-022X(1995)17:5<629:TIOLHO>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Keywords:
ACTH, CORTISOL, CRH; HEMODIALYSIS; HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL AXIS;
Tipo documento:
Note
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
L. Vigna et al., "THE IMPACT OF LONG-TERM HEMODIALYSIS ON PITUITARY-ADRENOCORTICAL FUNCTION", Renal failure, 17(5), 1995, pp. 629-637

Abstract

The activity of the hypoyhalamic-pituitary-adrenal axis in hemodialyzed (HD) patients has been investigated, with conflicting results. Different results are reported concerning both basal ACTH and cortisol concentration and the responses to different stimulating agents, in chronic hemodialyzed patients. The present study was performed in order to assess whether the length of the hemodialytic treatment may affect thepituitary and adrenocortical response to stimulation with ovine CRH (oCRH) and with exogenous ACTH in a group of patients on chronic HD formore than 10 years. Ten uremic patients (aged 38-71, 6 males and 4 females) on chronic hemodialysis for at least 10 years and 7 healthy subjects matched for age and sex were studied. The patients were rested on the day preceding dialysis session. Each subject received on different nonconsecutive days oCRH (100 mu g i.v. in bolus) and ACTH (Synacthen 0.25 mg i.v. in bolus), and blood samples were obtained at appropriate intervals. Basal ACTH and cortisol levels of HD patients were in the upper limit of normal range (ACTH 39.21 +/- 11.11 pg/mL in HD patients vs. 26.88 +/- 14.12 pg/mL, in controls; cortisol 19.96 +/- 5.07 inHD patients vs. 12.66 +/- 4.44 in controls), however the means were not significantly different compared with controls. Following oCRH administration a net increase ofACTH and cortisol was observed in every patient tested (ACTH peak 83.81 +/- 28.49 in HD vs. 78.73 +/- 22.87 pg/mL in controls; cortisol peak 30.73 +/- 19.31 in HD vs. 20.05 +/- 3.19 mu g/dL in controls). Comparing the ACTH and cortisol responses to oCRH obtained in HD pts and in controls, a mild delay in the maximum response peak ofACTH (peak at 60 min vs. 30 min) and a prolonged cortisol dismission was observed. Exogenous ACTH administration elicited a normal cortisol response in both HD patients and control groups. In conclusion, our results show that the responsiveness of the pituitary-adrenal axis is maintained in uremic patients, even after more than 10 yearsof chronic hemodialysis; the delayed ACTH response to oCRH might be considered a further manifestation of the disordered hypothalamic regulation described in uremia and/or it is probably due to a maladaptativeresponse to chronic stress.

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Documento generato il 21/01/20 alle ore 00:55:10