Free Plasma 11-Hydroxycorticosteroids and the Response to β^1β24-Corticotrophin in Regular Haemodialysis Patients

Abstract

The adrenocortical function of 59 patients on regular hemodialysis treatment was tested on 105 occasions by measuring the 30-min response of free plasma 11-hydroxycorticosteroids (11-OHCS) after intramuscular injection of 0.25 mg Synacthen® (β^1-24-corticotrophin). The morning basal levels of 11-OHCS were within the normal range. The increase of 11-OHCS after injection of Synacthen® was less than normal in 25% of the patients. In 9 patients with a low response an extended Synacthen® test was performed. This caused a normal increase in plasma 11-OHCS but the response came later than in normal persons. After 0.25 mg Synacthen® intramuscularly the 30-min response of 11-OHCS seemed to be lower on the first day than on the second day after dialysis. The present study supports the view that the pituitaryadrenocortical system is essentially intact in patients on regular hemodialysis treatment.