Get started
Work

Is plasma renin an helpful marker for mineralocorticoid adjustment in patient with adrenal insufficiency?

Year: 2023
Type: dissertation
Study design: Observational Study
Abstract: Although renin is an accurate marker of blood volume, there is currently no consensus on the value of plasma renin measurement for adjusting mineralocorticoid substitution in patients with adrenal insufficiency. The aim of this study was to determine if renin could be used in clinical practice to adjust the mineralocorticoid substitution in patients with primary adrenal insufficiency. We retrospectively included the data of patients followed for primary adrenal insufficiency in 2 tertiary expert Centers, namely the department of endocrinology of Assistance Publique-Hopitaux de Marseille, and the department of endocrinology of Caen hospital, between 2008 and 2022. Moreover, as hydrocortisone has its own mineralocorticoid activity, we integrated the individual hydrocortisone dose to obtain the mineralocorticoid equivalent dose (MC-Eq).A total of 150 patients were included, with a mean age at diagnosis of 29±7.8 years. Ours results showed that renin level was negatively correlated with both sodium (p<0.01) and systolic blood pressure (p=0.026), but positively with potassium (p<0.01). However, no correlation was found between plasma renin levels and Eq-MC (p=0.462). Interestingly, only 12.7% of patients had hyponatremia and/or hyperkalaemia, while renin was considered abnormal in 70.7%. We also demonstrated that increasing the dose of Eq-MC correlated with a significant decrease in renin levels, and vice versa (p=0.037). In conclusion, our results suggest that renin may provide more information than electrolytes alone regarding MC impregnation in patients with adrenal insufficiency. Given the current knowledge of the long-term consequences of inappropriate MC replacement, we believe that a future prospective study in a larger number of patients, with homogeneous guidelines to modify the dose of MC, is essential to determine the role of this marker in current practice.
Source: HAL AMU
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7001316120
Cites:
Cited by:
Related to: 10