title: Adrenal insufficiency presenting as unexplained hypotension in nocturnal home hemodialysis.
abstract: Adrenal insufficiency is a complication of chronic corticosteroid therapy. Unexplained hypotension may be a manifestation of an adrenal insufficient state in patients with a history of corticosteroid therapy on hemodialysis. We present a series of five cases of patients on nocturnal home hemodialysis with hypotension as the main manifestation of adrenal insufficiency. Unexplained hypotension in patients with a history of corticosteroid therapy should prompt the managing clinician to consider adrenal insufficiency as a possible cause.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.|Department of Renal Medicine, Division of Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Timothy Jee Kam
authors.initials: TJ
authors.lastname: Koh
authors.affiliation: Department of Internal Medicine, Division of Nephrology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chan
mesh_terms: D000309:Adrenal Insufficiency / Q000150:complications*; D000328:Adult; D005260:Female; D006437:Hemodialysis, Home / Q000009:adverse effects; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects
keywords: Adrenal insufficiency; corticosteroid therapy; hypotension; nocturnal home hemodialysis