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Cushing's syndrome after hemodialysis for 21 years

Koki Mise1, Yoshifumi Ubara, Keiichi Sumida

  • 1Nephrology Center, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatu-ku, Kawasaki-shi, Kanagawa-ken, 213-0015, Japan. kokimise@yahoo.co.jp

The Journal of Clinical Endocrinology and Metabolism
|November 24, 2012
PubMed

Insights

This case report details the first instance of adrenal Cushing's syndrome in a hemodialysis patient, presenting with hypokalemia and obesity. Treatment involved medication and adrenalectomy, resolving the patient's critical clinical issues.

Area of Science:

  • Endocrinology
  • Nephrology
  • Surgical Oncology

Background:

  • Hyperkalemia and weight loss are common challenges in hemodialysis patients.
  • Adrenal Cushing's syndrome is rarely reported in this population, especially with central obesity and hypokalemia.

Observation:

  • A 61-year-old woman on chronic hemodialysis for 21 years developed persistent hypokalemia and central obesity.
  • Endocrinological evaluation revealed increased cortisol secretion without a circadian rhythm and suppressed ACTH, indicative of adrenal Cushing's syndrome.

Findings:

  • Laparoscopic left adrenalectomy successfully removed an adrenal adenoma.
  • Post-surgery, hypokalemia resolved without medication, and weight gain ceased, confirming the diagnosis and effective treatment.

Implications:

  • This case highlights the importance of considering adrenal Cushing's syndrome in hemodialysis patients with unexplained hypokalemia and obesity.
  • Early diagnosis and surgical intervention can significantly improve patient outcomes and quality of life.
Abstract

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