Siamopoulos K C, Dardamanis M, Kyriaki D, Pappas M, Sferopoulos G, Alevisou V
Department of Nephrology, G. Hatzikosta General Hospital, Ioannina, Greece.
Perit Dial Int. 1990;10(2):153-6.
We investigated the effect of exogenous ovine corticotropin-releasing hormone (oCRH) on plasma levels of adrenocorticotropic hormone (ACTH) and cortisol in 24 chronic renal failure patients: 8 nondialysis (NDCRF), 8 on hemodialysis (HD), and 8 on continuous ambulatory peritoneal dialysis (CAPD). In all groups the acute administration of oCRH caused a further increase (less pronounced in NDCRF patients) in the already elevated levels of cortisol. Following oCRH administration, plasma ACTH rose significantly in CAPD patients, but there was a blunted response of the hormone in the NDCRF and HD groups. The patterns of the ACTH and cortisol response in the last two groups, resemble those observed in chronic stress. We conclude that the hypothalamic-pituitary-adrenal axis in chronic uremic patients, retains the ability to respond to exogenous oCRH. Patients on CAPD, however, display a better, identical to normal response, which can be due to less chronic stress and/or to the more effective clearance of uremic toxins.
我们研究了外源性羊促肾上腺皮质激素释放激素（oCRH）对24例慢性肾衰竭患者血浆促肾上腺皮质激素（ACTH）和皮质醇水平的影响，这些患者包括8例非透析患者（NDCRF）、8例血液透析患者（HD）和8例持续性非卧床腹膜透析患者（CAPD）。在所有组中，急性给予oCRH均导致已经升高的皮质醇水平进一步升高（在NDCRF患者中不太明显）。给予oCRH后，CAPD患者血浆ACTH显著升高，但NDCRF组和HD组中该激素的反应减弱。后两组中ACTH和皮质醇的反应模式与慢性应激时观察到的相似。我们得出结论，慢性尿毒症患者的下丘脑 - 垂体 - 肾上腺轴保留了对外源性oCRH作出反应的能力。然而，CAPD患者表现出更好的、与正常反应相同的反应，这可能是由于慢性应激较少和/或尿毒症毒素清除更有效。
