Atrial natriuretic peptide (ANP), aldosterone, angiotensin II and renin in the 'low T3 syndrome' in organ donors.
The present prospective study was conducted in order to investigate the effect of an acute decrease in serum T3 levels on ANP, aldosterone, angiotensin II, renin and ADH. All patients showed a pathologic TRH stimulation test prior to organ harvesting. Our patients developed secondary T3 hypothyroidism of different severity dependent on intensive care unit (ICU) stay. T3 values in group 1 (ICU stay > or = 77 h) were smaller than 70 ng/dl, those of group 2 (ICU stay < or = 53 h) were greater than 70 ng/dl. In both groups a severe elevation of plasma renin activity was measured, with almost high-normal values for ANP in group 1 and slightly elevated values in group 2 [not significant (n.s.)]. Results demonstrate that, contrary to patients who are not critically ill, brain-dead patients develop a dissociation of the renin-angiotensin-aldosterone mechanism. No statistical significant difference was found between the groups in serum levels of ADH and aldosterone. This endocrine dissociation, however, seems to have no clinical significance with regard to organ function after transplantation in kidney recipients.
Gottardis
M
M
Department of Anesthesia and General Intensive Care Medicine, University Hospital of Innsbruck, Austria.
Koller
J
J
Benzer
A
A
Wieser
C
C
Hackl
J M
JM
Koenigsrainer
A
A
Herold
M
M
Fridrich
L
L
D000450:Aldosterone / Q000097:blood*; D000804:Angiotensin II / Q000097:blood*; D009320:Atrial Natriuretic Factor / Q000097:blood*; D005067:Euthyroid Sick Syndromes / Q000097:blood*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D012083:Renin / Q000097:blood*; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000097:blood; D014019:Tissue Donors; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
D014284:Triiodothyronine; D000804:Angiotensin II; D000450:Aldosterone; D014285:Triiodothyronine, Reverse; D013973:Thyrotropin-Releasing Hormone; D009320:Atrial Natriuretic Factor; D013972:Thyrotropin; D012083:Renin; D013974:Thyroxine