Pituitary adrenocortical function in dialysed patients with chronic renal failure

Plasma levels of ACTH and cortisol were measured by radioimmunoassay in dialysed patients with chronic renal failure. Plasma ACTH levels were almost within the normal range and cortisol levels were slightly higher than the normal levels. Statistically significant difference in plasma ACTH and cortisol level was not found among the hypotensive, normotensive and hypertensive group in dialysed patients with chronic renal failure and there was no statistically significant correlation between the levels of plasma ACTH and cortisol. The mean levels of plasma cortisol before hemodialysis were higher than the levels after that and there was a significant difference between the ratio of plasma cortisol level before and after hemodialysis (Fa/Fb) and weight loss following hemodialysis and between Fa/Fb and of mean blood pressure. Diurnal rhythm of plasma ACTH and cortisol levels in dialysed patients with chronic renal failure were similar to the levels in healthy subjects. Rapid ACTH test showed normal response in the patients. These findings may indicate that pituitary adrenocortical function was almost normal and that there would be no possibility that the pituitary adrenocortical system plays a role as a hypotensive factor in dialysed patients with chronic renal failure.