A Rare Cause of Hypotension in Routine Hemodialysis: Secondary Adrenal Insufficiency

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Altunok M., Kızıltunç H. S., Çankaya E., Sevinç C., Uyanık A.

SEMINARS IN DIALYSIS, cilt.37, sa.4, ss.1-5, 2024 (SCI-Expanded)

  • Yayın Türü: Makale / Vaka Takdimi
  • Cilt numarası: 37 Sayı: 4
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1111/sdi.13225
  • Dergi Adı: SEMINARS IN DIALYSIS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, MEDLINE
  • Sayfa Sayıları: ss.1-5
  • Atatürk Üniversitesi Adresli: Evet

Özet

Hypotension is a common complication during hemodialysis that develops due to high ultrafiltration rate and sometimes requires

intravenous fluid replacement. Intradialytic hypotension may reduce the effectiveness of dialysis and contributes to

hemodialysis-related

morbidity and mortality. Adrenal insufficiency is one of the causes of hypotension in the community. Our

case was diagnosed with end-stage

renal failure and was undergoing routine hemodialysis with a central venous catheter 3 days a

week. Upon the patient's hypotension attacks during the dialysis sessions and hypoglycemia attacks in the follow-ups,

the morning

cortisol was 6.2 μg/dL. Adrenocorticotropic hormone was 39 pg/mL, and testosterone was 0.0442 ng/mL. Adrenocorticotropic

hormone stimulation test was performed on the patient with 250 mcg tetracosactide. The patient did not show adequate cortisol

response, was detected to have partial empty sella on pituitary magnetic resonance imaging, and was diagnosed with secondary

adrenal insufficiency, and then the hemodialysis hypotension improved with prednisolone treatment. We present a case of adrenal

insufficiency, which is a rare cause of hypotension in patients on routine hemodialysis