Effect of chronic renal failure on insulin, GH, thyroid hormone, gluco- and mineralocorticoid, ACTH and gonadotropin levels

Abstract

Symptoms suggesting hormone disorders are frequently observed in uremic children. Hence endocrine studies were performed in 2 groups of azotemic patients. In group I (n=11,age 2.7-17.5 years, serum creatinine 3.1 ± 0.7 mg/dl) basal serum insulin levels were increased, peak insulin values after oral glucose load were higher and markedly enhanced following arginine infusion compared to normal controls. Nevertheless carbohydrate tolerance was impaired in 4 patients. Basal GH levels and peak values following arginine infusion were significantly above normal.TRH exerted no effect on GH levels.Markedly decreased T3 values were found,T4 and basal TSH levels were unchanged,but TSH response to TRH was delayed.Diurnal plasma aldosterone levels correlated closer with the extent of hypertension than with the degree of uremia.Normal baseline plasma cortisol values with normal diurnal fluctuation were found,but cortisol increase following insulin-hypoglycemia was reducted.Basal ACTH plasma levels were elevated,but ACTH response to insulin-hypoglycemia was impaired.LH-RH injection led to normal or above normal LH and FSH values.- Group II was studied during hemodialysis: n=10,age 6.1-17.3 years,serum creatinine prior to dialysis 10.5±0.9 mg/dl. Higher basal levels of GH,insulin and ACTH were present. During hemodialysis ACTH,cortisol and insulin concentrations were increased.Despite high blood glucose GH levels were not suppressed. There was no definite change in TSH values during hemodialysis.