Related Experiment Video
Updated: Oct 5, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Endocrine alteration in the adrenal gland in kidney transplant patients
H Wunderlich1, D H Zermann, O Reichelt
1Department of Urology, Friedrich Schiller University, Jena, Germany.
Introduction:
Endocrine alterations associated with chronic renal failure have been reviewed recently. Some of these alterations are of clinical relevance. The aim of this study was to investigate the effect of renal transplantation on the endocrine system of the adrenal gland of the transplant recipients.
Methods:
The serum angiotensin-converting enzyme (SACE), plasma renin (PR) and plasma aldosterone (PA) were examined in 30 patients before and after renal allotransplantation. Additionally measured parameters were blood pressure, serum creatinine, potassium, sodium, the duration of dialysis and immunosuppressive medication.
Results:
Six weeks after renal transplantation, serum creatinine decreased from 820.07 +/- 172.01 to 138.12 +/- 67.54 micromol/l. In the same period, serum potassium decreased from 5.42 +/- 0.89 to 4.17 +/- 0.42 mmol/l. PA and PR decreased from 1,150.84 +/- 976.06 to 233.52 +/- 217.07 micromol/l, and from 121.07 +/- 100.12 to 26.16 +/- 10.86 microU/ml, respectively. SACE decreased from 0.21 +/- 0.21 to 0.13 +/- 0.11 micromol/l. No significant correlation was seen with blood pressure, serum sodium, the duration of dialysis and immunosuppressive drugs. Additionally, 2 patients with acute renal graft dysfunction showed significant increases in PR and PA. After successful treatment both levels declined very quickly to prerejection levels. Patients after binephrectomy show no elevation in PR (5-47 microU/ml) or PA (21-416 micromol/l) neither before nor after renal transplantation.
Conclusions:
We conclude that renal transplantation has profound effects on the recipient's renin-angiotensin-aldosterone system. Because of the rapid depression after renal transplantation, it does not appear to be involved in the pathogenesis of post transplantation hypertension but may reflect a role for repair processes after renal allotransplantation.
Insights
Renal transplantation significantly impacts the renin-angiotensin-aldosterone system, leading to rapid decreases in plasma renin and aldosterone. This suggests the system is not a primary cause of post-transplant hypertension but may indicate repair processes.
Area of Science:
- Endocrinology
- Nephrology
- Transplantation immunology
Background:
- Chronic renal failure is associated with endocrine alterations.
- Some endocrine changes in renal failure are clinically significant.
- Adrenal gland endocrine function in renal transplant recipients requires investigation.
Purpose of the Study:
- To investigate the effect of renal transplantation on the adrenal gland endocrine system.
- To assess changes in the renin-angiotensin-aldosterone system post-transplantation.
Main Methods:
- Measured serum angiotensin-converting enzyme (SACE), plasma renin (PR), and plasma aldosterone (PA) in 30 patients before and after renal allotransplantation.
- Monitored blood pressure, serum creatinine, potassium, and sodium levels.
- Recorded duration of dialysis and immunosuppressive medication.
Main Results:
- Renal transplantation led to significant decreases in serum creatinine and potassium levels six weeks post-surgery.
- Plasma aldosterone and renin levels markedly decreased after transplantation.
- Serum angiotensin-converting enzyme also showed a reduction; no significant correlation with blood pressure or dialysis duration was observed.
Conclusions:
- Renal transplantation profoundly affects the recipient's renin-angiotensin-aldosterone system.
- The rapid decline in this system post-transplantation suggests it may not be involved in post-transplant hypertension pathogenesis.
- These changes might reflect repair processes occurring after renal allotransplantation.
Related Concept Videos
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure
01:28Kidney Transplant I: Introduction
01:27Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
01:31Hormones of the Adrenal Glands
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and corticosterone...
01:13Introduction to Urinary System
The kidneys are bean-shaped organs located in the retroperitoneal space, on either side of the vertebral column, between the T12 and L3 vertebrae. They are partially protected by the rib cage and surrounded by perirenal fat, which provides cushioning. They are responsible for urine formation and play critical roles in regulating blood pressure, electrolyte levels, and hormone production. The ureters...