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18-Hydroxy-11-deoxycorticosterone in hypertensive uremic patients during hemodialysis
Insights
In hypertensive uremic patients undergoing hemodialysis, plasma 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) levels remained stable. Aldosterone decreased, but 18-OH-DOC showed no significant correlation with blood pressure or aldosterone during dialysis.
Area of Science:
- Nephrology
- Endocrinology
Background:
- Hypertensive uremic patients undergoing dialysis often experience fluid and electrolyte imbalances.
- The role of specific corticosteroids, like 18-hydroxy-11-deoxycorticosterone (18-OH-DOC), during hemodialysis requires further elucidation.
Purpose of the Study:
- To investigate the behavior of plasma 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) and aldosterone during hemodialysis in hypertensive uremic patients.
- To explore potential correlations between these hormones, blood pressure, and fluid/electrolyte shifts.
Main Methods:
- Radioimmunoassay and competitive protein binding techniques were used to measure plasma 18-OH-DOC, aldosterone, and corticosteroids.
- Measurements were taken before and at hourly intervals during a 3-hour hemodialysis session in 25 patients.
Main Results:
- Plasma 18-OH-DOC levels were normal before dialysis and did not change significantly during the procedure.
- Progressive decreases in body fluids and electrolytes were observed.
- No significant correlation was found between blood pressure and 18-OH-DOC during dialysis.
- Aldosterone levels decreased progressively, with 18-OH-DOC showing correlation with plasma corticosteroids only at the 3rd hour.
Conclusions:
- Hemodialysis does not significantly alter plasma 18-OH-DOC levels in hypertensive uremic patients.
- The observed decrease in aldosterone during dialysis may be influenced by factors like ACTH, but 18-OH-DOC's role appears independent in this context.
- Further research is needed to fully understand the complex hormonal regulation during renal replacement therapy.
Abstract:
The present study was carried out in 25 hypertensive uremic patients on regular 4 h dialysis, 3 times a week. Plasma 18-hydroxy-11-deoxycorticosterone (18-OH-DOC), aldosterone (PA) and corticosteroids were determined by radioimmunoassay and competitive protein binding technique before and at the end of the 1st, 2nd and 3rd hour of hemodialysis. Plasma 18-HD-DOC was normal before dialysis and did not change significantly during hemodialysis, whereas body fluids and electolytes decreased progressively. No correlation was observed between blood pressure and 18-OH-DOC during dialysis. 18-OH-DOC did not correlate with PA which decreases progressively during hemodialysis and was correlated to plasma corticosteroids only at the 3rd hour of dialysis, probably on account of the enhanced influence of ACTH on the adrenal cortex.