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Case Reports
. 2024 Apr;28(2):229-232.
doi: 10.1111/hdi.13131. Epub 2024 Feb 7.

Adrenal insufficiency in hemodialysis patients-An under-recognized problem: A case series

Krupa Shah  1 , Jeffrey Wong  1 , Kathy Mac  1 , Namson S Lau  1   2 , Vincent M Wong  1   2 , Angela Makris  1   2   3
Affiliations
Case Reports

Adrenal insufficiency in hemodialysis patients-An under-recognized problem: A case series

Krupa Shah et al. Hemodial Int. 2024 Apr.

Abstract

Adrenal insufficiency is an uncommon disorder and presents with non-specific symptoms. Identifying adrenal insufficiency in patients with chronic kidney disease requiring dialysis is increasingly difficult as there is a significant overlap of the signs and symptoms of adrenal insufficiency with those seen in chronic kidney failure. We highlight this diagnostic uncertainty in a case series of three patients with chronic kidney disease requiring hemodialysis as renal replacement therapy from a single center identified as hypoadrenal. Steroid replacement improved symptoms and hemodynamic parameters. Increased vigilance for adrenal insufficiency in dialysis patients is necessary. It is likely under recognized in hemodialysis patients given their multi-morbidity.

Keywords: adrenal insufficiency; glucocorticoid use; hemodialysis patients; kidney failure.

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References

REFERENCES

    1. Jameson J, Kasper D, Fauci A, Hauser S, Longo D, Loscalzo J, et al. Harrison's principles of internal medicine. New York, NY: McGraw Hill; 2019.
    1. Bancos I, Hahner S, Tomlinson J, Arlt W. Diagnosis and management of adrenal insufficiency. Lancet Diabetes Endocrinol. 2015;3(3):216–226.
    1. Kocyigit I, Unal A, Tanriverdi F, Hayri Sipahioglu M, Tokgoz B, Oymak O, et al. Misdiagnosis of Addison's disease in a patient with end‐stage renal disease. Ren Fail. 2011;33(1):88–91.
    1. Fofi C, Maresca B, Altieri S, Menè P, Festuccia F. Renal involvement in adrenal insufficiency (Addison disease): can we always recognize it? Intern Emerg Med. 2019;15(1):23–31.
    1. Koh TJ, Chan CT. Adrenal insufficiency presenting as unexplained hypotension in nocturnal home hemodialysis. Hemodial Int. 2016;20(3):E10–E13.

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