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Plasma 18-hydroxycorticosterone during continuous ambulatory peritoneal dialysis
The Journal of Laboratory and Clinical Medicine
|October 1, 1983
Summary
Continuous ambulatory peritoneal dialysis (CAPD) activates the renin-angiotensin system and adrenal zona glomerulosa. This study found elevated renin and 18-hydroxycorticosterone levels in CAPD patients, indicating hormonal system changes.
Area of Science:
- Endocrinology
- Nephrology
- Physiology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) involves prolonged dialysate exposure.
- Chronic ultrafiltration in CAPD may chronically activate the renin-angiotensin system and adrenal zona glomerulosa.
Purpose of the Study:
- To investigate the hypothesis that CAPD leads to chronic activation of the renin-angiotensin system and adrenal zona glomerulosa.
- To measure plasma levels of renin-angiotensin-aldosterone system components and related hormones in CAPD patients.
Main Methods:
- Measurement of plasma renin-activating activity (PRA), active renin (AR), total renin (TR), inactive renin (IR), 18-hydroxycorticosterone (18-OH-B), and plasma aldosterone (PAC).
- Samples collected under basal (recumbent) and stimulated (ambulation, ultrafiltration, ACTH infusion) conditions.
- Comparison with normal subjects.
Main Results:
- Elevated basal plasma levels of PRA, AR, TR, IR, and 18-OH-B were observed in CAPD patients.
- Plasma aldosterone (PAC) levels were normal at baseline.
- Following stimulation, PRA, AR, TR, IR, and PAC normalized, but 18-OH-B remained elevated, suggesting enhanced adrenal sensitivity.
Conclusions:
- CAPD activates the renin-angiotensin system, leading to increased circulating renin and likely angiotensin II.
- This activation stimulates the adrenal zona glomerulosa to increase secretion of 18-hydroxycorticosterone.
- The findings highlight hormonal adaptations in CAPD patients.