Metabolism of Adrenocortical Hormone in Patients with Chronic Impaired Renal Function

• Published in: The Japanese Journal of Nephrology Vol. 17; no. 9; pp. 823 - 836
• Main Authors: Terayama, Yuriko, Mikuni, Tsuneyasu, Hirayama, Nobuaki, Onodera, Takao, Suzuki, Tadashi, Nigawara, Kazuo, Sugawara, Shigeru, Funyu, Tomihisa, Ohno, Kazumi, Aoki, Keiji, Kudou, Shigenobu, Hitomi, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Nephrology 30.09.1975
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.17.823

Metabolism of adrenocortical hormone in patients with chronic impaired renal function was investigated in this study. Urinary 17-OHCS (total, free and fractions-com. F, comp. E, THF, THE) we(re measured by use of thin layer in these 12 patients, including 6 patients who were made to artificial dialysis. Three patients of them were studied on load with ACTH-Z 20 units/day for 3 days intramuscularly and 9 patients were studied on administration of cortisol (1 mg/kg of body weight) intra-venously. Moreover, blood free 11-OHCS was determined in 3 patients with treatment of artificial dialysis. Following results were obtained. 1) The excretion volume of urinary total 17-OHCS remained low coincidently with decrease in creatinine clearance on control, on load with ACTH-Z and on administration of cortisol. 2) In above mentioned patients, the rate of urinary free 17-OHCS to total 17-OHCS exhibited various values which may be influenced with glomerular and tubular lesion, being compared with certain values of normal control. 3) The fractions of urinary 17-OHCS showed small pattern similar to normal control. 4) The excretion pattern of urinary 17-OHCS fractions shifted to cortisol pathway from cortisone pathway on load with ACTH-Z as normal control. 5) In the group with non-hyper BUN, the changes of the excretion volume of urinary 17-OHCS was seemed to be similar to normal control in every 2 hours measurement on administration of cortisol, while in the group with hyper BUN, the changes was not observed. 6) In the patients with artificial dialysis free 11-OHCS remained within normal range but showed abnormal in diurnary variation.