• René Rodríguez-Gutiérrez, José G González-González, Alberto Martínez-Rodríguez, Erick Burciaga-Jiménez, Ricardo César Solís, Alejandro Díaz González-Colmenero, Luz Adriana Ramírez-García, Sofía Mariño-Velasco, and Francisco J Barrera-Flores.
• Endocrinology Department.
• Gac Med Mex. 2021 Jan 1; 157 (5): 502-507.

BackgroundAltered cortisol levels have been associated with an increase in mortality and a decrease in health-related quality of life in patients with chronic kidney disease (CKD); however, adrenal response to adrenocorticotropic hormone (ACTH) stimulation test has not been evaluated in patients with stage 3a to 5 CKD with and without renal replacement therapy (RRT).ObjectiveTo evaluate adrenal function in patients with CKD.Materials And MethodsAdults with CKD underwent a low-dose cosyntropin stimulation test (1 µg synthetic ACTH), with serum cortisol levels being measured at 0, +30 and +60 minutes post-test.ResultsSixty participants with stage 3, 4 and 5 CKD (with and without RRT) were included. None of the patients had adrenal insufficiency (AI). The correlation observed between cortisol concentration at baseline and 30 minutes and 1 hour after stimulation and glomerular filtration rate (GFR) was negative and statistically significant (r: -0.39 [p = 0.002], r: -0.363 [p = 0.004], r: -0.4 [p = 0.002], respectively).ConclusionSince CKD early stages, cortisol levels increase as GFR decreases. Therefore, we conclude that systematic screening for AI is not necessary in CKD patients.Copyright: © 2021 Permanyer.

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