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      Ovine Corticotropin-Releasing Hormone Stimulation Test in Patients with Chronic Renal Failure: Pharmacokinetic Properties, and Plasma Adrenocorticotropic Hormone and Serum Cortisol Responses

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          Abstract

          The data on the status of the hypothalamic-pituitary-adrenal (HPA) axis in haemodialysis (HD) patients are conflicting. Moreover, a state reminiscent of Cushing’s syndrome has been reported in this group of patients. Corticotropin-releasing hormone (CRH), that is produced by the hypothalamus and modulates the secretion of adrenocorticotropic hormone (ACTH), has been shown to be useful as a provocative test of the HPA axis. We investigated the effect of exogenous ovine CRH (oCRH) on plasma levels of ACTH and cortisol in 13 chronic HD patients. The plasma concentrations of immunoreactive CRH following oCRH administration were similar in patients and controls. In all patients, oCRH given intravenously as bolus injection caused a further increase in the already elevated levels of cortisol. The mean basal plasma levels of ACTH were within the normal range. There was, however, a blunted ACTH response to oCRH. We conclude that the HPA axis in chronic HD patients retains the ability to respond to exogenous oCRH. The patterns of the ACTH and cortisol response to this peptide resemble those observed in chronic stress (depression, anorexia nervosa). Besides, the kinetics of disappearance of oCRH indicate that the kidney may not be the major organ that metabolizes oCRH.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          1663-2818
          1663-2826
          1988
          1988
          02 December 2008
          : 30
          : 1
          : 17-21
          Affiliations
          aDepartment of Nephrology and bUniversity Laboratory of Clinical Biochemistry, ‘G. Hatzikosta’ General Hospital, Ioannina, Greece
          Article
          181019 Horm Res 1988;30:17–21
          10.1159/000181019
          2851525
          © 1988 S. Karger AG, Basel

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          Page count
          Pages: 5
          Categories
          Original Paper

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