Cited by 34Adrenal Hormones and DisordersHormonal Regulation and HypertensionRenin-Angiotensin System Studies

Control of mineralocorticoid substitution in Addison's disease by plasma renin measurement

Oelkers, W., L'age, M.·1976·Klinische Wochenschrift

Abstract

In 7 out-patients with Addison's disease, plasma renin activity (PRA), plasma concentrations of angiotensin II (AT II), renin substrate (PRS), potassium, sodium and total protein, hematocrit, blood pressure, heart rate and body weight were studied after 2 weeks each on 2 mg of dexamethasone, 25 mg hydrocortisone (HC), 25 mg HC + 0.05 mg 9-alpha-fluorohydrocortisone (FC), 25 mg HC + 0.1 mg FC and 25 mg HC + 0.2 MG FC. Four further patients were less extensively studied. Mean PRA (upper normal limit, ambulatory: 12 ng AT I-ml-1-h-1) after the 5 steps of incremental substitution, starting with dexamethasone, was 192, 59, 38, 24 and 9 ng AT I-ml-1-h-1 rsp. PRS did not change with increasing substitution. PRA and AT II were significantly correlated (r = 0.91; p less than 0.0001) and proved to be the most sensitive parameters of insufficient mineralocorticoid substitution. With decreasing significance, PRA also correlated with plasma protein concentration, plasma sodium concentration (negative), delta body weight (negative), heart rate, delta mean blood pressure (negative) and plasma potassium concentration. PRA or AT II measurements are useful clinical tools to control mineralocorticoid substitution in Addisonian patients. Inappropriately high substitution can be prevented by keeping PRA in the upper normal range.

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Crossref · 10.1007/bf01469025

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Authors
Oelkers, W., & L'age, M.
Affiliations
Freie Universität Berlin (DE)
Venue
Klinische Wochenschrift
Published
1976-07
Volume
54
Issue
13
Pages
607-612
ISSN
  • 0946-2716 (ISSN-L)
  • 0023-2173
  • 1432-1440
OpenAlex
W91700561
Cited by
34
References
19
Citations by year
2026: 2 · 2023: 2 · 2021: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 6
FWCI
1.72
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Molecular Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords
Addison's disease, plasma renin activity, angiotensin II, renin substrate, cortisol, 9-alpha-fluorohydrocortisone, dexamethasone, blood pressure, plasma sodium, plasma potassium
MeSH terms
Addison Disease, Angiotensin II, Angiotensinogen, Dexamethasone, Drug Administration Schedule, Fludrocortisone, Humans, Hydrocortisone, Mineralocorticoids, Renin

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