17-ketosteroids and Kidney-Failure--Chronic

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocortical Hyperfunction; Chemistry, Clinical; Corticosterone; Cushing Syndrome; Diagnosis, Differential; Female; Glucocorticoids; Humans; Hydrocortisone; Hypogonadism; Kidney Failure, Chronic; Male; Methods; Obesity; Pregnancy; Pregnancy Complications

A 48-year-old man was admitted for treatment of Cushing's syndrome due to right adrenal adenoma, associated with chronic renal failure (CRF) with a blood urea nitrogen level of 64.2 and serum creatinine level of 3.9 mg/dl. After removal of the adrenal adenoma, the CRF deteriorated with progressive symptoms of anorexia, vomiting and hypertension, and the patient was placed on hemodialysis. Prior to adrenalectomy, the 17 OHCS and 17 KGS in the urine were not so high. However, the urinary 17 KS was high with an elevated 11-oxy fraction. In comparison with 2 patients suffering from adrenal Cushing's syndrome with normal renal function, there were no large accumulated quantities of glucuronic conjugated and unconjugated metabolites in the plasma of the CRF Cushing's syndrome, with confirmation ascribable to the radioimmunoassayable cross-reactivity of the cortisol antiserum used in the radioimmunoassay kit. In the Cushing's syndrome with CRF, almost all the cortisol, which was hypersecreted from the adenoma, was presumed to be converted to the 11-oxy fraction of 17 KS, possibly by activation of hepatic enzymes.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Gland Neoplasms; Adult; Cushing Syndrome; Female; Humans; Hydrocortisone; Kidney Failure, Chronic; Male; Middle Aged

Topics: 17-Ketosteroids; Adrenal Cortex; Female; Humans; Hydroxycorticosteroids; Kidney Failure, Chronic; Male; Renal Dialysis

Bilateral slipped upper femoral epiphysis is a rare manifestation of renal osteodystrophy. A case of bilateral slipped femoral epiphysis in an 18-year old male suffering from chronic renal failure due to oligomeganephronic renal hypoplasia with profound signs of renal osteodystrophy is presented. Serum growth hormone levels were high, while those of urinary 17-ketosteroids were decreased. Following subtotal parathyroidectomy, the progression of the process leading to slipped epiphysis was halted with closure of the epiphyses. The patient was subsequently treated with chronic hemodialysis for several months, after which successful renal transplantation was performed. The pathogenesis of renal osteodystrophy leading to slipped epiphysis is discussed and attention drawn to the fact that bilateral slipped femoral epiphysis may be the first clinical sign of chronic renal insufficiency.

Topics: 17-Ketosteroids; Adolescent; Adult; Chronic Kidney Disease-Mineral and Bone Disorder; Epiphyses, Slipped; Femur; Growth Hormone; Humans; Kidney Failure, Chronic; Kidney Transplantation; Knee; Male; Parathyroid Glands; Radiography; Renal Dialysis; Transplantation, Homologous

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Aged; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Sex Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenocorticotropic Hormone; Adult; Body Weight; Estriol; Female; Humans; Hyperemesis Gravidarum; Kidney Failure, Chronic; Maternal-Fetal Exchange; Metyrapone; Obstetric Labor, Premature; Pituitary-Adrenal System; Placenta Previa; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pregnancy in Diabetics; Pregnanediol; Pregnanetriol; Rupture; Thrombosis; Uterine Hemorrhage

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Cortisone; Dietary Carbohydrates; Dietary Proteins; Humans; Kidney Failure, Chronic; Male; Nitrogen; Norethandrolone; Proteins; Starvation; Sucrose; Water-Electrolyte Balance

Topics: 17-Ketosteroids; Addison Disease; Adrenocorticotropic Hormone; Adult; Female; Glomerular Filtration Rate; Humans; Kidney; Kidney Failure, Chronic; Male; Water-Electrolyte Balance