Effects of Haemodialysis Session on Plasma Beta-Endorphin, ACTH and Cortisol in Patients with End-Stage Renal Disease

Abstract

The effect of a regular haemodialysis session on the plasma concentrations of beta-endorphin, ACTH and cortisol was investigated in 14 patients with end-stage renal disease and 20 healthy controls. Blood for analysis of beta-endorphin, ACTH and cortisol was sampled before and immediately after haemodialysis. In four patients the dialysate was studied for presence of these hormones, but showed no specific activity. The predialysis beta-endorphin, ACTH and cortisol levels did not differ significantly from the control values. The postdialysis levels were significantly higher than the predialysis. Significant linear correlation was found between plasma ACTH and beta-endorphin values in the postdialysis samples. The similarity of plasma beta-endorphin, ACTH and cortisol levels in patients with end-stage renal disease before dialysis and in normal controls indicated integrity of the hypothalamic pituitary-adrenal axis. The significantly increased levels after the dialysis session and the significant correlation between postdialysis plasma beta-endorphin and ACTH suggest that the haemodialysis session was a stressful event.

Sleep pattern in an experimental model of chronic kidney disease

“…Although most studies have demonstrated HPA axis integrity in patients with renal failure (20,33), our findings revealed a greater activation of the HPA axis and a high level of stress. Therefore, it is necessary to emphasize that chronic or prolonged stress responses may cause several disease states (45) and contribute to important sleep pattern changes (42).…”

The Relationship between Renal Function and Plasma Concentration of the Cachectic Factor Zinc-Alpha2-Glycoprotein (ZAG) in Adult Patients with Chronic Kidney Disease

“…Glucocorticoids are described to increase ZAG secretion [35], [36]. And cortisol level has been shown to be increased by hemodialysis session [37] suggesting that glucocorticoids could enhance ZAG secretion and contribute to the perdialytic increase in plasma ZAG concentration. In contrast, inflammatory cytokines such as TNF-alpha were shown to decreased ZAG secretion [38]–[40].…”

Chronic Kidney Disease and Hypertension

“…Obviously, assessing 24-h urinary-free cortisol excretion largely depends on how precisely an individual patient collects urine and on her/his renal function. Plasma binding protein concentrations and dexamethasone clearance can be significantly altered with decreased renal function [143,196,197]. Recent studies have [195], with permission from The Endocrine Society) shown a disrupted circadian cortisol rhythm in patients with ESRD, whereas previous studies showed normal rhythms [197][198][199][200].…”