beta-endorphin and Kidney-Failure--Chronic

The effect of a regular haemodialysis session on the plasma concentrations of beta-endorphin, ACTH and cortisol was investigated in 14 patients with end-stage renal disease and 20 healthy controls. Blood for analysis of beta-endorphin, ACTH and cortisol was sampled before and immediately after haemodialysis. In four patients the dialysate was studied for presence of these hormones, but showed no specific activity. The predialysis beta-endorphin, ACTH and cortisol levels did not differ significantly from the control values. The postdialysis levels were significantly higher than the predialysis. Significant linear correlation was found between plasma ACTH and beta-endorphin values in the postdialysis samples. The similarity of plasma beta-endorphin, ACTH and cortisol levels in patients with end-stage renal disease before dialysis and in normal controls indicated integrity of the hypothalamic pituitary-adrenal axis. The significantly increased levels after the dialysis session and the significant correlation between postdialysis plasma beta-endorphin and ACTH suggest that the haemodialysis session was a stressful event.

Topics: Adrenocorticotropic Hormone; Adult; Aged; beta-Endorphin; Circadian Rhythm; Female; Humans; Hydrocortisone; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis

The effects of dyadic satisfaction and conflict have not been well defined in the hemodialysis (HD) population. The aim of this study was to determine whether the perception of decreased dyadic satisfaction was associated with mortality in patients treated with HD, and if so, whether there were different relationships between risk factors, and differential outcomes in men and women. A total of 174 HD patients, primarily African-Americans, involved in dyadic relationships for more than 6 mo had indices of dyadic satisfaction, depression, perception of illness effects, social support, behavioral compliance with the dialysis prescription, and plasma interleukin-1 (IL-1) and beta-endorphin levels measured. Cox proportional hazards models assessed relative mortality risks. Patients' dyadic satisfaction scores correlated with beta-endorphin levels. There was no correlation of IL-1 or beta-endorphin with any psychosocial or behavioral compliance measure in the group as a whole. Correlations between psychosocial, medical, and neuroimmunologic variables were different in men and women. For women, dyadic satisfaction correlated with beta-endorphin levels, depression, and perception of illness. Women with higher dyadic satisfaction and decreased dyadic conflict were at decreased mortality risk, but dyadic adjustment indices were unassociated with differential survival in the larger group of men. Correlations between neuroendocrine and immune markers are different in African-American male and female HD patients. Greater dyadic satisfaction and lower dyadic conflict are independently associated with decreased mortality in female African-American HD patients, of the same order of magnitude as medical risk factors. Such effects may be attributable to a relationship between dyadic satisfaction and conflict and health-related behaviors, or through an effect on neuroendocrine or immunologic status.

Topics: Adult; Aged; Aged, 80 and over; Attitude to Health; beta-Endorphin; Black or African American; Conflict, Psychological; Depression; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Personal Satisfaction; Proportional Hazards Models; Renal Dialysis; Risk Factors; Sex Distribution; Spouses; Urban Population

In CRF patients many endocrine abnormalities were observed. BE levels are elevated in CRF patients and HD treatment do not decrease it. In the other hand during rHu-EPO therapy many changes previously observed during CRF, in hormones concentrations partially are normalised. The aim of present study was to find answer on the following questions: 1. Are there any differences in plasma BE levels between hemodialysed CRF patients treated with rHu-EPO and in untreated, 2. Does rHu-EPO therapy have any influence on plasma BE level during HD session? Fourty CRF hemodialysed patients were divided into 2 groups. Group 1 consist of 18 patients (10 female and 8 male with mean age 41.6 +/- 16.3 years) treated with rHu-EPO during last 3-9 months (50 u.i./kg b.m.) intravenously after each HD session. Group II consist of 22 patients (11 both female and male with mean age 46.2 +/- 17.9 years) untreated with rHu-EPO. From CRF patients blood sample were taken 4 times: before HD, in 120 min. of HD in front of and behind dialyzer and in 240 min. This procedure was provided follow HD sessions using bicarbonate buffer with polysulphone dialyzer. Control plasma BE concentration was established from 40 healthy subjects with mean age 39.6 +/- 12.7 years as 24.9 +/- 7.6 pmol/l. Plasma BE level was assessed using RIA method (INCSTAR). Mean plasma BE level in control group was significantly lower then in CRF groups. There were no differences in plasma BE levels between examined CRF groups. We concluded that elevated in CRF patients plasma BE concentration does not modify by rHu-EPO treatment and that in both examined groups plasma BE concentration does not change during HD session.

Topics: Adolescent; Adult; Aged; beta-Endorphin; Erythropoietin; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis

In order to examine the role of endogenous opioid peptides on glucose metabolism in uraemic patients, plasma concentrations of beta-endorphin, glucose, insulin and C-peptide were determined before and during an oral glucose tolerance test (OGTT) in nine non-dialysed patients with chronic renal failure (CRF). The results are compared with those obtained in a group of age-matched normal subjects. In CRF patients, plasma beta-endorphin fasting values (16.0 +/- 1.9 pmol/l) were significantly higher than those of the controls (6.6 +/- 0.6 pmol/l) and significantly correlated with the degree of renal function impairment. After glucose load, plasma beta-endorphin in CRF patients tended to decline, whereas in normal subjects increased. The fasting and the mean OGTT plasma beta-endorphin values negatively correlated with insulin initial response to glucose, insulin and C-peptide mean OGTT values, but not with glucose OGTT mean values. Data indicate that chronic uraemia induces a significant increase in circulating plasma beta-endorphin levels, with a loss of opioid system responsiveness to glucose. The possibility that this hyper-endorphinism may have a biological importance at least as a contributory factor of impaired glucose tolerance in uraemia may be suggested.

Topics: Adult; Aged; beta-Endorphin; Blood Glucose; C-Peptide; Fasting; Female; Glucose Tolerance Test; Humans; Insulin; Kidney Failure, Chronic; Male; Middle Aged

Endogenous opioid peptides play an important role in the pathogenesis of uraemic syndrome. The effect of insulin-induced hypoglycaemia on serum beta-endorphin (BE) concentration was studied in 27 uraemic patients and in 14 healthy subjects. Despite elevated basal BE level, that correlated positively with serum creatinine, uraemic patients showed a normal BE secretory pattern. No differences were found between uraemic patients on conservative and those on haemodialysis treatment. The influence of haemodialysis treatment on BE secretion requires further investigations.

Topics: Adult; beta-Endorphin; Blood Glucose; Humans; Insulin; Kidney Failure, Chronic; Middle Aged; Renal Dialysis; Uremia

In patients with chronic renal failure (CRF) an elevated serum beta-endorphin (BE) level and lack of a twenty-four-hour BE-secretory pattern were found. BE and other opioid peptides participate significantly in the development of the uremic syndrome and its complications. On the other hand hemodialytic treatment is an important factor influencing the concentration of most hormones. In healthy subjects insulin-induced hypoglycemia as well as exogenous corticotropin releasing hormone (CRH) produce a rise in serum BE since BE, beta-lipotropin and ACTH come from the common precursor proopiomelanocortin (POMC). This paper intended to evaluate the curve of serum BE concentration during such a test in uremic patients on hemodialytic treatment. 13 patients with CRF hemodialysed 4 to 38 months (mean: 17 months) and 14 healthy subjects were examined. In each of them crystalline insulin (0.1 units/kg of body mass) was given intravenously and blood samples were collected every 30 minutes. BE concentration was measured by radioimmunoassay without previous chromatographic separation. The test was performed after an overnight rest in the morning in persons staying at the recumbent position. An adequate hypoglycemia was obtained in every subject. Basal serum BE concentration was significantly higher in patients with CRF than in healthy subjects and correlated positively with duration of hemodialytic treatment. After 60 min. from insulin injection in both groups the peak BE level was observed whereas after 120 min. in returned to the initial values. The curve of BE concentration in patients with CRF ran on a significantly higher level than in healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; beta-Endorphin; Female; Humans; Hypoglycemia; Insulin; Kidney Failure, Chronic; Male; Middle Aged; Reference Values; Renal Dialysis

During bicarbonate hemodialysis, there is an increase in peripheral vascular resistance of nonadrenergic origin, counteracting the hypotensive effect of fluid removal during the course of the dialysis. In this study, the plasma levels of vasoactive regulatory peptides, noradrenaline and renin, were investigated in 11 patients with chronic renal failure during standard bicarbonate hemodialysis (STHD) for 270 min. As regards vasoconstrictors, an increase in gamma 2-melanocyte-stimulating hormone (gamma 2-MSH), neuropeptide Y (NPY) and plasma renin activity (PRA) occurred. However, arginine vasopressin and noradrenaline were unchanged. With respect to vasodilators, calcitonin gene-related peptide was not changed. An initial increase in beta-endorphin (beta-END) occurred, followed by a decrease during the remaining part of the treatment. Motilin decreased during the first part of the treatment but increased to the baseline level during the latter part. An increase in substance P was observed while vasoactive intestinal peptide decreased. We conclude that an increase in vasoconstricting substances (gamma 2-MSH, NPY, PRA) occurs during STHD, probably owing to the decrease in plasma volume. With the exception of beta-END, the changes in vasodilators were fairly small. The data suggest that vasoactive substances might participate in the hemodynamic response to hemodialysis.

Topics: Adult; Aged; Aged, 80 and over; Arginine Vasopressin; beta-Endorphin; Bicarbonates; Calcitonin Gene-Related Peptide; Female; Hemodynamics; Humans; Hypotension; Kidney Failure, Chronic; Male; Melanocyte-Stimulating Hormones; Middle Aged; Neuropeptide Y; Neuropeptides; Norepinephrine; Renal Dialysis; Renin

The hemodynamic response to isolated ultrafiltration (IUF) is characterized by a vasoconstriction, while there is no significant change in peripheral vascular resistance during isovolemic bicarbonate hemodialysis (IVHD). The present investigation was designed to study the plasma levels of vasoactive regulatory peptides together with noradrenaline (NA) and plasma renin activity (PRA) in 11 patients during sequential hemodialysis (SQHD) - IUF for 60 min, followed by IVHD for 210 min. During IUF, the vasoconstrictors arginine vasopressin (AVP), gamma 2-melanocyte-stimulating hormone (gamma 2-MSH), neuropeptide Y (NPY), NA and PRA increased. During IVHD, NPY and PRA remained unchanged on a higher level. A decrease in AVP below the baseline and in gamma 2-MSH and NA to the baseline levels occurred during IVHD. In the case of vasodilators, there were no changes in calcitonin gene-related peptide or motilin during SQHD. An increase in beta-endorphin (beta-END) occurred during IUF, followed by a decrease during IVHD. Substance P and vasoactive intestinal peptide were unchanged during IUF but decreased during IVHD. We conclude that SQHD is characterized by an increase in all the measured vasoconstrictors during IUF in response to loss of fluid, and by a decrease in some vasoconstrictors (AVP, gamma 2-MSH, NA) during IVHD. With the exception of beta-END, there were no changes or only minor ones in vasodilators during SQHD. There are changes in plasma levels of vasoactive substances during SQHD but the importance of these changes for the hemodynamic adaptation to ultrafiltration and dialysis needs to be studied further.

Topics: Adult; Aged; Aged, 80 and over; Arginine Vasopressin; beta-Endorphin; Bicarbonates; Female; Hemodynamics; Humans; Kidney Failure, Chronic; Male; Melanocyte-Stimulating Hormones; Middle Aged; Neuropeptide Y; Neuropeptides; Norepinephrine; Renal Dialysis; Renin; Ultrafiltration

beta-endorphin (BE) and other opioid peptides participate significantly in the development of the uremic syndrome. In patients with chronic renal failure (CRF) an elevated serum BE level and lack of a twenty-four-hour BE-secretory pattern were found. In 14 patients with CRF on conservative treatment with serum creatinine above 500 mumol/l and in 14 healthy subjects serum BE was evaluated after intravenous insulin injection. An adequate hypoglycemia was obtained in every subject. Basel serum BE concentration was significantly higher in patients with CRF than in healthy subjects and correlation positively with creatinine. After 60 min. from insulin injection in both groups the peak BE level was observed here after 120 min. it returned to the initial values. The curve of BE concentration in patients with CRF ran significantly higher than in healthy subjects. A total secretory answer of the pituitary measured by the area over basel value of BE was similar in both groups. It seems that BE secretion by the corticotropic cells of the pituitary is unchanged in patients with CRF. Impaired BE elimination by the kidneys is probably responsible for hyper-beta-endorphin levels in those patients.

Topics: Adult; beta-Endorphin; Female; Humans; Hypoglycemia; Insulin; Kidney Failure, Chronic; Male; Middle Aged

An improvement of quality of life and objective brain function has been reported in patients receiving regular hemodialysis treatment (RDT) during treatment with recombinant human erythropoietin (r-huEPO). The mechanisms explaining this improvement are unknown. In this study the plasma levels of peptides known to be involved in CNS functions, namely corticotropin-releasing hormone, delta sleep-inducing peptide, beta-endorphin, methionine-enkephalin, beta-lipotropin and alpha-melanocyte-stimulating hormone, were measured by radioimmunoassay in seven stable RDT patients before the start of r-huEPO therapy and during 28 weeks' treatment. All patients responded with significantly increased hemoglobin concentrations. An improvement of well-being, state of mood and physical fitness was reported by the patients. There were no significant changes during the study in the plasma concentrations of any of the peptides measured. However, as the plasma levels of neuropeptides will not necessarily reflect the local concentrations in the vicinity of the nerve terminals, changes in the intracerebral concentrations of these peptides might occur in response to r-huEPO.

Topics: Adult; Aged; alpha-MSH; beta-Endorphin; beta-Lipotropin; Corticotropin-Releasing Hormone; Delta Sleep-Inducing Peptide; Endorphins; Enkephalin, Methionine; Erythropoietin; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Recombinant Proteins; Renal Dialysis

The fasting plasma levels of 10 vasoactive regulatory peptides were measured by radioimmunoassay in 23 stable patients with chronic renal failure receiving regular hemodialysis treatment (RDT) and compared with those of healthy controls. The plasma concentrations of arginine vasopressin, atrial natriuretic peptide, beta-endorphin, methionine-enkephalin, motilin, neuropeptide Y, substance P, and vasoactive intestinal peptide were increased. The plasma level of calcitonin gene-related peptide was not statistically different from that of the controls. The plasma concentration of gamma 2-melanocyte-stimulating hormone was lowered in the RDT-patients. The arterial blood pressure correlated with the plasma levels of motilin and neuropeptide Y. We conclude that patients with chronic renal failure receiving RDT have increased concentrations of 8 out of 10 measured vasoactive regulatory peptides. The elevated levels of vasoactive peptides may contribute to the adaptation of the cardiovascular system to impaired renal function.

Topics: Adult; Aged; Aged, 80 and over; Arginine Vasopressin; Atrial Natriuretic Factor; beta-Endorphin; Blood Pressure; Enkephalin, Methionine; Female; Humans; Kidney Failure, Chronic; Kidney Function Tests; Male; Middle Aged; Motilin; Neuropeptide Y; Neuropeptides; Renal Dialysis; Substance P; Vascular Resistance; Vasoactive Intestinal Peptide

Whether the plasma concentration of beta endorphin was increased in hepatic cirrhosis like that of smaller opioid peptides methionine enkephalin and leucine enkephalin was determined. Its concentration in chronic renal failure was also measured. Plasma beta endorphin was not significantly raised in cirrhotic patients with or without ascites (medians 5.2 pmol/l and 4.7 pmol/l respectively) compared with disease control subjects (4.9 pmol/l) and healthy control subjects (4.9 pmol/l). In contrast, the peptide was increased 2.5 fold (p less than 0.001) in chronic renal failure (12.4 pmol/l) and was found in many of these patients' urine. The data are compatible with the hypothesis that the liver may play an important role in the elimination of opioid peptides of octapeptide size or less but not the larger peptides such as beta endorphin.

Topics: beta-Endorphin; Humans; Kidney Failure, Chronic; Liver Cirrhosis

The effects of a vegetarian low-protein, low-phosphorus diet supplemented with essential amino acids and ketoanalogues, on the serum beta-endorphin, growth hormone, parathyroid hormone, thyroid hormones (T3 and T4), pituitary TSH and total cortisol were studied in 12 male chronic uremics. beta-Endorphin decreased, as well as growth hormone. Parathyroid hormone and T3 improved significantly, reaching almost normal values. It is hypothesized that the correction of the beta-endorphin excess may account in part for the improvement of some endocrinological and metabolic effects exerted by this dietary treatment. The possible pathophysiological mechanisms which could explain the antiendorphinic action of this treatment in uremic patients are discussed, as well as the possible beneficial endocrine and metabolic effects exerted by the fall in circulating beta-endorphin.

Topics: Adolescent; Adult; Amino Acids; beta-Endorphin; Food, Fortified; Humans; Keto Acids; Kidney; Kidney Failure, Chronic; Male; Nitrogen; Phosphorus

The recently described human corticotropin-releasing factor was administered to eight patients with chronic renal failure in order to assess hypothalamic-pituitary-adrenocortical (HPA) function. Acute administration of corticotropin-releasing factor lead to a diminished increase of the basally elevated levels of ACTH and beta-endorphin immunoreactivity in patients on chronic hemodialysis. Basal plasma cortisol concentration was normal in end-stage renal disease; however, considering the corresponding elevated ACTH concentrations, cortisol levels were inadequately low. Thus, the hypothalamus as well as the adrenal gland seems to contribute to the alterations in HPA function observed in patients with chronic renal failure; involvement of the pituitary gland and effects of metabolic alterations cannot be ruled out.

Topics: Adrenocorticotropic Hormone; Adult; beta-Endorphin; Corticotropin-Releasing Hormone; Endorphins; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Kidney Failure, Chronic; Male; Middle Aged; Pituitary-Adrenal System; Renal Dialysis

The effect of hemodialysis on the plasma concentration of beta-endorphin (beta-EP) and beta-lipotropin (beta-LPH) was studied in 11 patients with end-stage renal disease (ESRD). The plasma beta-EP/beta-LPH concentrations measured at 13.00 h were not significantly different in the patients compared to age-matched controls. Furthermore, hemodialysis produced no change in the plasma concentrations of beta-EP/beta-LPH. The elevated levels of beta-EP/LPH previously reported are most likely a reflection of the measurement of these peptides at a time of peak diurnal secretion compounded by a fall in the metabolic clearance rate of the endogenous opioids in ESRD. It remains to be established whether measurement of adronocorticotropic hormone or beta-EP/beta-LPH is more accurate an indicator of the integrity of the hypothalamic-pituitary-adrenal axis in patients with ESRD.

Topics: Adult; Aged; beta-Endorphin; beta-Lipotropin; Blood Pressure; Circadian Rhythm; Endorphins; Female; Humans; Hypothalamo-Hypophyseal System; Kidney Failure, Chronic; Male; Middle Aged; Pituitary-Adrenal System; Renal Dialysis

Topics: beta-Endorphin; Depression; Endorphins; Humans; Kidney Failure, Chronic; Renal Dialysis; Stress, Psychological

ACTH and lipotropins (beta- and gamma-LPH) are synthesized from a common precursor by the pituitary corticotropic cell. We have measured LPH plasma levels under physiological and pathological conditions and we have compared them with ACTH plasma levels in the same circumstances. Spontaneous variations (nycthemeral rhythm) in LPH, ACTH and cortisol plasma levels were parallel, while responses to Dexamethasone freination test and stress (Insulin induced hypoglycemia) or more specific stimulation (Metopirone, lysine-vasopressin) were parallel and superimposable. LPH levels were always higher than ACTH levels in two pathological circumstances: chronic renal failure and Cushing's syndromes with ectopic ACTH producing tumors. The determination of both ACTH and LPH levels assists the diagnosis of corticotropic insufficiency and etiologic investigation of Cushing's syndrome, after hypercorticolism had been established. Although unable to confirm the presence of corticotropic adenoma in patients with Cushing's disease, or the predict effectiveness of pituitary surgery, these determination bring good arguments for treated Cushing's diseases follow up.

Topics: Adenoma; Adrenocorticotropic Hormone; beta-Endorphin; beta-Lipotropin; Cushing Syndrome; Endorphins; Humans; Hypopituitarism; Kidney Failure, Chronic; Pituitary Neoplasms; Pituitary-Adrenal Function Tests

Topics: Addison Disease; Adrenalectomy; Adrenocorticotropic Hormone; beta-Endorphin; beta-Lipotropin; Cushing Syndrome; Dexamethasone; Endorphins; Enkephalin, Methionine; Enkephalins; Humans; Hydrocortisone; Insulin; Kidney Failure, Chronic; Male