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Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus.
Ann Rheum Dis. 2004 Aug; 63(8):961-8.AR

Abstract

BACKGROUND

In rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), patients demonstrate low levels of adrenal hormones.

OBJECTIVE

To investigate whether increased renal clearance and daily excretion contribute to this phenomenon.

METHODS

Thirty patients with RA, 32 with SLE, and 54 healthy subjects (HS) participated. Serum and urinary levels of cortisol, cortisone, 17-hydroxyprogesterone (17OHP), androstenedione, dehydroepiandrosterone (DHEA), and DHEA sulphate (DHEAS) were measured.

RESULTS

Clearance of DHEAS and DHEA was lower in patients than in HS, and clearance of androstenedione was somewhat higher in patients than in HS, but daily excretion of this latter hormone was low. Clearance of cortisol, cortisone, and 17OHP was similar between the groups. The total molar amount per hour of excreted DHEA, DHEAS, and androstenedione was lower in patients than HS (but similar for cortisol). Serum DHEAS levels correlated with urinary DHEAS levels in HS and patients, whereby HS excreted 5-10 times more of this hormone than excreted by patients. Low serum levels of adrenal androgens and cortisol in patients as compared with HS were confirmed, and proteinuria was not associated with changes of measured renal parameters.

CONCLUSIONS

This study in patients with RA and SLE demonstrates that low serum levels of adrenal androgens and cortisol are not due to increased renal clearance and daily loss of these hormones. Decreased adrenal production or increased conversion or conjugation to downstream hormones are the most likely causes of inadequately low serum levels of adrenal hormones in RA and SLE.

Authors+Show Affiliations

Department of Internal Medicine I, University Hospital Regensburg, D-93042 Regensburg, Germany. rainer.straub@klinik.uni-regensburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15249323

Citation

Straub, R H., et al. "Renal Clearance and Daily Excretion of Cortisol and Adrenal Androgens in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus." Annals of the Rheumatic Diseases, vol. 63, no. 8, 2004, pp. 961-8.
Straub RH, Weidler C, Demmel B, et al. Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus. Ann Rheum Dis. 2004;63(8):961-8.
Straub, R. H., Weidler, C., Demmel, B., Herrmann, M., Kees, F., Schmidt, M., Schölmerich, J., & Schedel, J. (2004). Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus. Annals of the Rheumatic Diseases, 63(8), 961-8.
Straub RH, et al. Renal Clearance and Daily Excretion of Cortisol and Adrenal Androgens in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus. Ann Rheum Dis. 2004;63(8):961-8. PubMed PMID: 15249323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal clearance and daily excretion of cortisol and adrenal androgens in patients with rheumatoid arthritis and systemic lupus erythematosus. AU - Straub,R H, AU - Weidler,C, AU - Demmel,B, AU - Herrmann,M, AU - Kees,F, AU - Schmidt,M, AU - Schölmerich,J, AU - Schedel,J, PY - 2004/7/14/pubmed PY - 2004/8/11/medline PY - 2004/7/14/entrez SP - 961 EP - 8 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 63 IS - 8 N2 - BACKGROUND: In rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), patients demonstrate low levels of adrenal hormones. OBJECTIVE: To investigate whether increased renal clearance and daily excretion contribute to this phenomenon. METHODS: Thirty patients with RA, 32 with SLE, and 54 healthy subjects (HS) participated. Serum and urinary levels of cortisol, cortisone, 17-hydroxyprogesterone (17OHP), androstenedione, dehydroepiandrosterone (DHEA), and DHEA sulphate (DHEAS) were measured. RESULTS: Clearance of DHEAS and DHEA was lower in patients than in HS, and clearance of androstenedione was somewhat higher in patients than in HS, but daily excretion of this latter hormone was low. Clearance of cortisol, cortisone, and 17OHP was similar between the groups. The total molar amount per hour of excreted DHEA, DHEAS, and androstenedione was lower in patients than HS (but similar for cortisol). Serum DHEAS levels correlated with urinary DHEAS levels in HS and patients, whereby HS excreted 5-10 times more of this hormone than excreted by patients. Low serum levels of adrenal androgens and cortisol in patients as compared with HS were confirmed, and proteinuria was not associated with changes of measured renal parameters. CONCLUSIONS: This study in patients with RA and SLE demonstrates that low serum levels of adrenal androgens and cortisol are not due to increased renal clearance and daily loss of these hormones. Decreased adrenal production or increased conversion or conjugation to downstream hormones are the most likely causes of inadequately low serum levels of adrenal hormones in RA and SLE. SN - 0003-4967 UR - https://www.unboundmedicine.com/medline/citation/15249323/Renal_clearance_and_daily_excretion_of_cortisol_and_adrenal_androgens_in_patients_with_rheumatoid_arthritis_and_systemic_lupus_erythematosus_ L2 - https://ard.bmj.com/lookup/pmidlookup?view=long&pmid=15249323 DB - PRIME DP - Unbound Medicine ER -