Plasma metanephrines in renal failure
| Autor: | Macclellan M. Walther, Karel Pacak, Graeme Eisenhofer, Jacques W.M. Lenders, Fred C.G.J. Sweep, F.T.M. Huysmans |
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| Rok vydání: | 2005 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty renal failure Health aging / healthy living [IGMD 5] Epinephrine medicine.medical_treatment Urology Adrenal Gland Neoplasms Renal function Pheochromocytoma Aetiology screening and detection [ONCOL 5] Vascular medicine and diabetes [UMCN 2.2] Normetanephrine urologic and male genital diseases chemistry.chemical_compound Norepinephrine Translational research [ONCOL 3] Internal medicine medicine Humans Renal Insufficiency Metanephrine Dialysis Aged Cardiovascular diseases [NCEBP 14] business.industry Endocrinology and reproduction [UMCN 5.2] Hormonal regulation [IGMD 6] Metanephrines Middle Aged medicine.disease Renal disorders [UMCN 5.4] Endocrinology chemistry normetanephrine dialysis Kidney Failure Chronic Female business Kidney disease |
| Zdroj: | Kidney International. Supplement, 67, 2, pp. 668-77 Kidney International. Supplement, 67, 668-77 |
| ISSN: | 2157-1724 |
| Popis: | Contains fulltext : 49181.pdf (Publisher’s version ) (Closed access) BACKGROUND: Diagnosis of pheochromocytoma in renal failure poses a diagnostic dilemma due to lack of reliability of conventional urinary measurements of catecholamine excess. Measurements of the plasma metanephrines, normetanephrine and metanephrine (the O-methylated metabolites of norepinephrine and epinephrine), provide an alternative diagnostic test. The metanephrines may be measured as free metabolites or after a deconjugation step where measurements reflect mainly sulfate-conjugated metabolites. The influence of renal insufficiency states on these various measurements is unclear. METHODS: Plasma free and deconjugated metanephrines and catecholamines in 17 patients on dialysis with end-stage renal disease and 19 patients with renal insufficiency (creatinine clearance, 5-78 mL/min) were compared with levels in 89 hypertensives, 68 healthy normotensives, and 51 patients with von Hippel-Lindau syndrome. RESULTS: Patients with renal failure had up to two-fold higher plasma concentrations of catecholamines and free metanephrines, and more than 12-fold higher plasma concentrations of deconjugated metanephrines than comparison groups. Plasma free metanephrines and catecholamines were, respectively, within the 95% confidence intervals of reference groups in 75% and 42% of the dialysis patients, and in 74% and 68% of patients with renal insufficiency. In contrast, no dialysis patient and only half the renal insufficiency patients had plasma levels of deconjugated metanephrines within the reference intervals. Plasma levels of deconjugated metanephrines, but not free metanephrines, showed strong inverse relationships with creatinine clearance. CONCLUSION: Plasma concentrations of free metanephrines are relatively independent of renal function and are, therefore, more suitable for diagnosis of pheochromocytoma among patients with renal failure than measurements of deconjugated metanephrines. |
| Databáze: | OpenAIRE |
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