ECE2018 Poster Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (70 abstracts)
Does Hemodialysis (HD) affect the overall testosterone (T) and luteinizing hormone (LH) levels in T-treated hypogonadal Congenital Adrenal Hyperplasia (CAH) male with associated chronic kidney disease (CKD)? A pilot single center matched case report
Zoran Gluvic , Milena Lackovic 1 , Vladimir Samardzic 1 , Jelena Tica Jevtic 1 , Marina Vujovic 1 , Bojan Mitrovic 1 , Vesna Popovic-Radinovic 1 , Violeta Mladenovic 2 , Jovana Kusic 1 , Rodoljub Markovic 1 , Tamara Jemcov 1 & Esma R. Isenovic 3
1Zemun Clinical Hospital, Zemun, Serbia. 2Clinic for Endocrinology, Kragujevac, Serbia. 3Lab. for radiobiology and molecular endocrinology, Institute for nuclear sciences “Vinca”, Belgrade, Serbia.
Introduction: CAH is among the most common inherited metabolic disturbances, caused by Ar mutations of genes that encode enzymes involved in the adrenal steroids synthesis. Male hypogonadism and CKD can complicate the course of CAH. Additionally, HD can influence the CAH management by unpredictable effects of ultrafiltration on the levels of administered drugs. The aim of our study is to demonstrate the influence of HD on LH/T levels of eugonadal male as well hypogonadal male with CAH under T-substitution, both with CKD.
Material and Methods: CAH 38-years-old male and age/gender-matched control has had a regular thrice-weekly maintenance HD on the same device (Gambro AK200 Ultra S) in Zemun Clinical Hospital. CAH hypogonadal male is under parenteral T 250 mg (D1) on regular 3-weeks intervals. According to approved study protocol, blood samples were collected in determined points (D0, 1, 7, 14, 21 for T-treated and D0 and 21 for control patient) for the purpose of T and LH measurements before and after HD session. Analyses were performed by DXI-600 Beckman Coulter device.
Results: Obtained data are showed in Table.
Discussion: Our results demonstrated the regular male age-related LH/T levels in control examinee, with no significant change after HD sessions. T level at D0 lower than normal revealed that patient was not T-overdosed (i.e. regarding previous T-dose and interval of administration). The expected trends of T-levels increase and LH-levels decrease were registered in initial control points of T-treated patient. However, the other way round trend of the observed hormone levels were registered in later control points in the same patient. Additionally, there were no extreme changes in the LH/T levels before and after HD sessions at control points in both examinees. The ultimate control point hormone levels of both examinees were in the reference range.
| Hormones | Before T (D0) | D1 | D7 | D14 | D21 | |||||
| <HD | >HD | <HD | >HD | <HD | >HD | <HD | >HD | <HD | >HD | |
| LHC (1.2–8.6) [U/l] | 6.52 | 6.90 | 6.20 | 5.66 | ||||||
| TC (6.07–27.1) [nmol/l] | 7.66 | 7.44 | 8.63 | 7.59 | ||||||
| LHTt | 18.61 | 22.74 | 26.51 | 1.72 | 2.17 | 0.86 | 0.41 | 2.91 | 2.79 | |
| TTt | 5.85 | 15.97 | 12.66 | 12.04 | 17.33 | 11.11 | 11.11 | 7.89 | 9.23 | |
| HD=Hemodialysis;< - before HD; > - after HD; D=day; C=control patient; Tt=testosterone-treated patient. | ||||||||||
Conclusion: HD does not significantly influence LH/T levels in eugonadal and T-treated hypogonadal CAH patient, both associated with CKD. The LH/T levels are reliable markers of the quality of T-substitution in HD-treated patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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