Aldosterone Response to Insulin-Induced Hypoglycemia in Hemodialysis Patients
作者:
German Ramirez,
Arunabha Ganguly,
Carl Bruegemeyer,
Celso Gomez-Sanchez,
期刊:
American Journal of Nephrology
(Karger Available online 1989)
卷期:
Volume 9,
issue 3
页码: 215-221
ISSN:0250-8095
年代: 1989
DOI:10.1159/000167968
出版商: S. Karger AG
关键词: Aldosterone;Hypoglycemia;Hemodialysis
数据来源: Karger
摘要:
To investigate possible abnormalities of the hypothalamic-pituitary axis in patients with chronic renal failure on dialysis, we have examined the effects of insulin-induced hypoglycemia on the adrenal steroid responses. In normal subjects, plasma aldosterone and Cortisol concentrations increase significantly in response to hypoglycemia, with good correlation. In the patients with end-stage renal disease (ESRD) however, insulin-induced hypoglycemia fails to elicit significant increases in the plasma Cortisol and aldosterone levels. To test the adrenal responsiveness to adrenocorticotropin (ACTH), we administered ACTH to both groups. Plasma Cortisol and aldosterone responses are similar in both groups suggesting that the adrenal responsiveness to ACTH is not impaired. We also investigated the responsiveness of the renin-angiotensin-aldosterone system in response to volume contraction by hemofiltration in patients with ESRD. Neither plasma renin activity nor plasma aldosterone concentration change significantly following such contrived volume contraction. These results reveal several endocrinologic abnormalities in the patients with ESRD on chronic hemodialysis.
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