[Effect of hemodialysis on the pituitary adrenocortical axis in patients with diabetic nephropathy]. 1996

D Moczulski, and E Zukowska-Szczechowska, and W GrzeszCzak, and M Tomaszewski, and M Augustyn, and K Gosek
Katedry i Kliniki ChorĂ³b Wewnetrznych i Zawodowych Slaskiej Akademii Medycznej w Zabrzu.

Pituitary-adrenocortical axis is disturbed in patients with chronic renal failure. Such abnormalities have been described in diabetic patients, too. The studies were performed to answer the following questions: 1) Is there a difference in basal ACTH and cortisol plasma level between patients with diabetic nephropathy and normal subjects? 2) Does haemodialysis affect ACTH and cortisol plasma level in patients with diabetic nephropathy? 18 patients with diabetic nephropathy and 10 normal controls were the subjects of this study. Blood samples for ACTH and cortisol determination were collected from each patient with diabetic nephropathy four times: before haemodialysis from the arterial line of dialyzer (0a) after 60 minutes of haemodialysis from the arterial (60a) and the venous (60v) line of dialyzer and after 240 minutes of haemodialysis from the arterial line (240a). Blood samples from normal controls were collected at 6 a.m. to determine ACTH and cortisol level. All the diabetic patients were on chronic 4-hour-haemodialysis 3 times a week. An artificial kidney Fresenius 4008 E, polysulfone dialyzers F5 and acetate dialysing solution were used in the studies. Plasma samples were analyzed for cortisol and ACTH by RIA. The studies brought to following conclusions: 1) The basal ACTH plasma level is significantly higher in patients with diabetic nephropathy than in normal controls. There is no significant difference in cortisol plasma level between diabetic patients and the control group. 2) Haemodialysis effects significant decrease of ACTH in plasma of diabetic patients. There is no statistic significance in cortisol plasma level in diabetic patients during haemodialysis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010902 Pituitary Gland A small, unpaired gland situated in the SELLA TURCICA. It is connected to the HYPOTHALAMUS by a short stalk which is called the INFUNDIBULUM. Hypophysis,Hypothalamus, Infundibular,Infundibular Stalk,Infundibular Stem,Infundibulum (Hypophysis),Infundibulum, Hypophyseal,Pituitary Stalk,Hypophyseal Infundibulum,Hypophyseal Stalk,Hypophysis Cerebri,Infundibulum,Cerebri, Hypophysis,Cerebrus, Hypophysis,Gland, Pituitary,Glands, Pituitary,Hypophyseal Stalks,Hypophyses,Hypophysis Cerebrus,Infundibular Hypothalamus,Infundibular Stalks,Infundibulums,Pituitary Glands,Pituitary Stalks,Stalk, Hypophyseal,Stalk, Infundibular,Stalks, Hypophyseal,Stalks, Infundibular
D003928 Diabetic Nephropathies KIDNEY injuries associated with diabetes mellitus and affecting KIDNEY GLOMERULUS; ARTERIOLES; KIDNEY TUBULES; and the interstitium. Clinical signs include persistent PROTEINURIA, from microalbuminuria progressing to ALBUMINURIA of greater than 300 mg/24 h, leading to reduced GLOMERULAR FILTRATION RATE and END-STAGE RENAL DISEASE. Diabetic Glomerulosclerosis,Glomerulosclerosis, Diabetic,Diabetic Kidney Disease,Diabetic Nephropathy,Intracapillary Glomerulosclerosis,Kimmelstiel-Wilson Disease,Kimmelstiel-Wilson Syndrome,Nodular Glomerulosclerosis,Diabetic Kidney Diseases,Glomerulosclerosis, Nodular,Kidney Disease, Diabetic,Kidney Diseases, Diabetic,Kimmelstiel Wilson Disease,Kimmelstiel Wilson Syndrome,Nephropathies, Diabetic,Nephropathy, Diabetic,Syndrome, Kimmelstiel-Wilson
D005260 Female Females
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006854 Hydrocortisone The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. Cortef,Cortisol,Pregn-4-ene-3,20-dione, 11,17,21-trihydroxy-, (11beta)-,11-Epicortisol,Cortifair,Cortril,Epicortisol,Hydrocortisone, (11 alpha)-Isomer,Hydrocortisone, (9 beta,10 alpha,11 alpha)-Isomer,11 Epicortisol
D000324 Adrenocorticotropic Hormone An anterior pituitary hormone that stimulates the ADRENAL CORTEX and its production of CORTICOSTEROIDS. ACTH is a 39-amino acid polypeptide of which the N-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotrophic activity. Upon further tissue-specific processing, ACTH can yield ALPHA-MSH and corticotrophin-like intermediate lobe peptide (CLIP). ACTH,Adrenocorticotropin,Corticotropin,1-39 ACTH,ACTH (1-39),Adrenocorticotrophic Hormone,Corticotrophin,Corticotrophin (1-39),Corticotropin (1-39),Hormone, Adrenocorticotrophic,Hormone, Adrenocorticotropic
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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