[Influence of long term dialysis therapy on function of the pituitary-adrenal axis in patients with chronic renal failure].

Chronic renal failure is often associated with the pituitary-adrenal axis disturbances. In this paper the influence of long term dialysis therapy on the pituitary-adrenal axis functions was investigated. The examinations were carried out in 12 non-dialysed patients compared with 12 patients dialysed 1-50 months, 12 patients dialysed 51-100 months, 12 dialysed longer than 100 months and 12 healthy subjects as a control. In all the serum glucose, ACTH and cortisol levels just before and after hypoglycaemia induced by intravenous insulin administration (0.1 j./kg body weight) were determined. The following results were obtained. 1. In subjects with chronic renal failure the basic ACTH and cortisol levels (a part from patients dialysed longer than 100 months) were significantly increased than in controls. 2. There were no significant differences in ACTH levels in non-dialysed and dialysed shorter than 100 months subjects. 3. The basic cortisol levels were significantly lower in patients dialysed longer than 50 months in non-dialysed or dialysed shorter. 4. The increase of ACTH serum levels caused by hypoglycaemia induced by intravenous insulin was more marked in patients dialysed 50-100 months, than in others. 5. There were no significant differences in mean changes cortisol after insulin induced hypoglycaemia in all groups with chronic renal failure but was lower than in healthy subjects. Conclusions. The long term dialysis seems to influence the pituitary-adrenal axis function in patients with chronic renal failure.