Hyponatraemia in older people as a sign of adrenal insufficiency: a case-control study

2010 ◽  
Vol 42 (3) ◽  
pp. 306-310 ◽  
Author(s):  
T. Winchester Behr ◽  
M. Sonnenblick ◽  
G. Nesher ◽  
G. Munter
2015 ◽  
Vol 25 (8) ◽  
pp. 517-521 ◽  
Author(s):  
Shih-Chang Hung ◽  
Kuan-Fu Liao ◽  
Chih-Hsin Muo ◽  
Shih-Wei Lai ◽  
Chia-Wei Chang ◽  
...  

2008 ◽  
Vol 58 (551) ◽  
pp. e1-e9 ◽  
Author(s):  
Rachel E Jordan ◽  
Jeremy I Hawker ◽  
Jon G Ayres ◽  
Peymané Adab ◽  
William Tunnicliffe ◽  
...  

2019 ◽  
Vol 35 (12) ◽  
pp. 2191-2197 ◽  
Author(s):  
Amalie Valentin ◽  
Stina Willemoes Borresen ◽  
Marianne Rix ◽  
Thomas Elung-Jensen ◽  
Søren Schwartz Sørensen ◽  
...  

Abstract Background Maintenance immunosuppressive regimens after renal transplantation (RTx) most often include prednisolone, which may induce secondary adrenal insufficiency, a potentially life-threatening side effect to glucocorticoid (GC) treatment due to the risk of acute adrenal crisis. We investigated the prevalence of prednisolone-induced adrenal insufficiency in RTx patients receiving long-term low-dose prednisolone treatment. Methods We performed a case–control study of patients on renal replacement therapy differing in terms of GC exposure. The study included 30 RTx patients transplanted >11 months before enrolment in the study and treated with prednisolone (5 or 7.5 mg prednisolone/day for ≥6 months) and 30 dialysis patients not treated with prednisolone. Patients underwent testing for adrenal insufficiency by a 250-µg Synacthen test performed fasting in the morning after a 48-h prednisolone pause. Normal adrenal function was defined as P-cortisol ≥420 nmol/L 30 min after Synacthen injection. This cut-off is used routinely for the new Roche Elecsys Cortisol II assay and is validated locally based on the Synacthen test responses in 100 healthy individuals. Results Thirteen RTx patients {43% [95% confidence interval (CI) 27–61]} had an insufficient response to the Synacthen test compared with one patient in the control group [3% (95% CI 0.6–17)] (P = 0.0004). Insufficient responses were seen in 9/25 and 4/5 RTx patients treated with 5 and 7.5 mg prednisolone/day, respectively. Conclusions We found a high prevalence of adrenal insufficiency among RTx patients receiving low-dose prednisolone treatment. We therefore advocate for increased clinical alertness towards prednisolone-induced adrenal insufficiency in RTx patients and thus their potential need of rescue GC supplementation during stress.


2020 ◽  
Vol 20 (5) ◽  
pp. 482-487
Author(s):  
Yasuyuki Arai ◽  
Takao Suzuki ◽  
Seungwon Jeong ◽  
Yusuke Inoue ◽  
Masahiko Fukuchi ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Camilla M. Hoyos ◽  
Christopher Gordon ◽  
Zoe Terpening ◽  
Louisa Norrie ◽  
Simon J. G. Lewis ◽  
...  

2010 ◽  
Vol 26 (6) ◽  
pp. 602-607 ◽  
Author(s):  
Chia-Ming Chang ◽  
Ming-Jen Chen ◽  
Chun-Yu Tsai ◽  
Lun-Hui Ho ◽  
Hsing-Ling Hsieh ◽  
...  

2017 ◽  
Vol 38 (4) ◽  
pp. 277-285 ◽  
Author(s):  
María Morales-Suárez-Varela ◽  
Agustín Llopis-González ◽  
Carlos Vergara-Hernández ◽  
Estrella Fernandez-Fabrellas ◽  
Francisco Sanz ◽  
...  

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