ECE2022 Poster Presentations Adrenal and Cardiovascular Endocrinology (87 abstracts)
Renin indicates the mineralocorticoid activity of fludrocortisone: a 6-year study in primary adrenal insufficiency
Filippo Ceccato 1 , Marianna Torchio 2 , Irene Tizianel 2 , Mattia Barbot 2 , Chiara Sabbadin 2 , Corrado Betterle 2 & Carla Scaroni 2
1Department of Medicine, University of Padova, Padova, Italy; 2Department of Medicine, University of Padova, Italy
Context: Fludrocortisone (FC) is the mineralocorticoid (MC) replacement treatment for patients with primary adrenal insufficiency (PAI).
Objective: To explore the dose of FC treatment and its relationship with glucocorticoid therapy, sodium, potassium, renin and clinical parameters.
Design: Longitudinal study.
Setting: Monocentric cohort.
Patients: Data of 193 patients with PAI (130 autoimmune) were collected during baseline (T0), intermediate (T1) and last follow-up visit (T2, respectively after 38 and 35 months).
Main Outcome Measure: Utility of endocrine and clinical parameters to titrate FC dose.
Results: FC dose (50-75 μg/daily) was stable in the follow-up in half patients. The MC activity of FC was dose-dependent: we observed a positive linear correlation between FC dose and sodium (r=0.132) and negative linear correlation between FC and potassium (r=-0.162) or renin (r=-0.131, all P <0.01). An overall reduction in the FC dose was observed at T2 in the group with longer follow-up (>60 months, P <0.05). Higher doses of FC were observed in patients with low-normal renin, especially in autoimmune PAI (86 vs 65 μg/daily, P <0.05). On the contrary, reduced sodium and increased potassium levels were observed in patients with high renin at T2. The number of cardiovascular events (15 in the whole cohort) was similar in patients sorted by renin levels or FC dose.
Conclusions: Renin and electrolytes are marker of MC activity: they should be routinely evaluated and used to titrate FC treatment, because FC dose can be reduced in the long-term follow-up.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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