Adrenal function testing in dialysis patients – a review of the literature

Abstract Background Secondary adrenal insufficiency is a frequent issue in patients with renal replacement therapy. There are concerns about metabolism and clearance for adrenocorticotropic hormone (ACTH) and cortisol in addition to hemoconcentration as confounding factors during hemodialysis (HD)....

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Lara Brotzer, Manuela Nickler, Min Jeong Kim, Beat Mueller, Claudine A. Blum
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	ACTH test Corticotropin test Adrenal insufficiency Hemodialysis Renal replacement Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/a5374b2b29a649fda8ff1ccfe0db11b8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a5374b2b29a649fda8ff1ccfe0db11b8
record_format	dspace
spelling	oai:doaj.org-article:a5374b2b29a649fda8ff1ccfe0db11b82021-11-08T11:18:10ZAdrenal function testing in dialysis patients – a review of the literature10.1186/s12882-021-02541-51471-2369https://doaj.org/article/a5374b2b29a649fda8ff1ccfe0db11b82021-11-01T00:00:00Zhttps://doi.org/10.1186/s12882-021-02541-5https://doaj.org/toc/1471-2369Abstract Background Secondary adrenal insufficiency is a frequent issue in patients with renal replacement therapy. There are concerns about metabolism and clearance for adrenocorticotropic hormone (ACTH) and cortisol in addition to hemoconcentration as confounding factors during hemodialysis (HD). Therefore, ACTH testing is currently performed before or in between HD sessions. This review of the literature aims to evaluate the current evidence for validity of testing for adrenal insufficiency in patients on chronic renal replacement therapy. Methods A literature search of PubMed database for interventional and observational clinical trials was performed. Case reports and reviews were excluded. The search included all articles published until July 2020. Results Of 218 potentially eligible articles, 16 studies involving 381 participants were included. Seven studies performed an ACTH test before HD or in between HD sessions. There was no data available regarding ACTH testing during HD. But there was evidence of decreased cortisol levels during HD as compared to afterwards. All included 16 studies measured basal cortisol, and seven studies performed an ACTH test. Seven trials had comparable data of baseline cortisol for a quantitative analysis. Standardized mean difference of overall cortisol was 0.18 nmol/l (95%CI − 0.08 to 0.44) in the case group. Conclusions In patients undergoing renal replacement therapy, basal serum cortisol values are comparable to healthy volunteers. There is limited data on the validity of stimulated cortisol in these patients, especially during HD. Trial registration Registration no. CRD42020199245 .Lara BrotzerManuela NicklerMin Jeong KimBeat MuellerClaudine A. BlumBMCarticleACTH testCorticotropin testAdrenal insufficiencyHemodialysisRenal replacementDiseases of the genitourinary system. UrologyRC870-923ENBMC Nephrology, Vol 22, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ACTH test Corticotropin test Adrenal insufficiency Hemodialysis Renal replacement Diseases of the genitourinary system. Urology RC870-923
spellingShingle	ACTH test Corticotropin test Adrenal insufficiency Hemodialysis Renal replacement Diseases of the genitourinary system. Urology RC870-923 Lara Brotzer Manuela Nickler Min Jeong Kim Beat Mueller Claudine A. Blum Adrenal function testing in dialysis patients – a review of the literature
description	Abstract Background Secondary adrenal insufficiency is a frequent issue in patients with renal replacement therapy. There are concerns about metabolism and clearance for adrenocorticotropic hormone (ACTH) and cortisol in addition to hemoconcentration as confounding factors during hemodialysis (HD). Therefore, ACTH testing is currently performed before or in between HD sessions. This review of the literature aims to evaluate the current evidence for validity of testing for adrenal insufficiency in patients on chronic renal replacement therapy. Methods A literature search of PubMed database for interventional and observational clinical trials was performed. Case reports and reviews were excluded. The search included all articles published until July 2020. Results Of 218 potentially eligible articles, 16 studies involving 381 participants were included. Seven studies performed an ACTH test before HD or in between HD sessions. There was no data available regarding ACTH testing during HD. But there was evidence of decreased cortisol levels during HD as compared to afterwards. All included 16 studies measured basal cortisol, and seven studies performed an ACTH test. Seven trials had comparable data of baseline cortisol for a quantitative analysis. Standardized mean difference of overall cortisol was 0.18 nmol/l (95%CI − 0.08 to 0.44) in the case group. Conclusions In patients undergoing renal replacement therapy, basal serum cortisol values are comparable to healthy volunteers. There is limited data on the validity of stimulated cortisol in these patients, especially during HD. Trial registration Registration no. CRD42020199245 .
format	article
author	Lara Brotzer Manuela Nickler Min Jeong Kim Beat Mueller Claudine A. Blum
author_facet	Lara Brotzer Manuela Nickler Min Jeong Kim Beat Mueller Claudine A. Blum
author_sort	Lara Brotzer
title	Adrenal function testing in dialysis patients – a review of the literature
title_short	Adrenal function testing in dialysis patients – a review of the literature
title_full	Adrenal function testing in dialysis patients – a review of the literature
title_fullStr	Adrenal function testing in dialysis patients – a review of the literature
title_full_unstemmed	Adrenal function testing in dialysis patients – a review of the literature
title_sort	adrenal function testing in dialysis patients – a review of the literature
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a5374b2b29a649fda8ff1ccfe0db11b8
work_keys_str_mv	AT larabrotzer adrenalfunctiontestingindialysispatientsareviewoftheliterature AT manuelanickler adrenalfunctiontestingindialysispatientsareviewoftheliterature AT minjeongkim adrenalfunctiontestingindialysispatientsareviewoftheliterature AT beatmueller adrenalfunctiontestingindialysispatientsareviewoftheliterature AT claudineablum adrenalfunctiontestingindialysispatientsareviewoftheliterature
_version_	1718442268160950272

Adrenal function testing in dialysis patients – a review of the literature

Ejemplares similares