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Published on: September 15, 2017
Uraemia and adrenocortical function in Nigerian subjects
A O Ogunlesi1, A O Akanji, S Kadiri
1Department of Medicine, University College Hospital, Ibadan, Nigeria.
African Journal of Medicine and Medical Sciences
|March 1, 1990
Summary
Uraemic Nigerians exhibit an abnormal pituitary-adrenal axis, with disrupted cortisol rhythms and elevated urinary free cortisol (UFC). This suggests a pseudo-Cushingoid state in uraemia, potentially linked to hypertension and electrolyte issues.
Area of Science:
- Endocrinology
- Nephrology
- Human Physiology
Background:
- The pituitary-adrenal axis regulates cortisol secretion, crucial for stress response and metabolism.
- Uraemia, a consequence of kidney failure, can lead to hormonal imbalances.
- Previous studies suggested a pseudo-Cushingoid state in uraemia among Caucasian populations.
Purpose of the Study:
- To investigate the pituitary-adrenal axis function in uraemic Nigerians.
- To assess circadian cortisol rhythm, dexamethasone suppression response, and urinary free cortisol (UFC) excretion.
- To determine if uraemia in Nigerians presents a similar pseudo-Cushingoid state.
Main Methods:
- Compared 10 uraemic subjects with 9 non-uraemic controls.
- Measured plasma cortisol at 0800 h and 2300 h.
- Administered an overnight 1 mg dexamethasone suppression test.
- Analyzed 24-hour urinary free cortisol (UFC) excretion.
Main Results:
- Basal (0800 h) plasma cortisol levels were similar between groups.
- Uraemic subjects lacked the normal late-night reduction in cortisol.
- Dexamethasone failed to suppress cortisol in uraemic subjects, unlike controls.
- 24-hour UFC excretion was significantly higher in uraemic subjects.
Conclusions:
- Uraemic Nigerians exhibit a disrupted circadian cortisol rhythm and impaired dexamethasone suppression.
- Elevated UFC excretion in uraemic Nigerians confirms a pseudo-Cushingoid state.
- This hormonal imbalance may contribute to hypertension and electrolyte abnormalities in uraemia.
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