Hormonal changes in haemodialysed and in kidney-transplanted patients.

A total of 48 haemodialysed patients were studied by radioimmunoassay for the serum concentrations of parathormone, calcitonin, gastrin, insulin, prolactin, T3, T4, rT3, TSH and cortisol. Residual urines were measured for cAMP and ultrafiltrates for iPTH and gastrin. The duration of the dialysis programme, the number of haemodialysis sessions per week, sex distribution, the dialysis alternatives (including haemofiltration, haemoperfusion) and successful kidney transplantations were correlated with the serum hormone levels. Significant increases in PTH, gastrin and prolactin values were demonstrated in the dialysed patients. However, their calcitonin and insulin concentrations decreased, parallel with the time elapsed since the start of the haemodialysis programme (HDP). The number of dialysis sessions per week was found to affect the hormone concentrations diversely. In the course of haemofiltration and haemoperfusion some of the hormone levels (e.g. PTH, gastrin) decreased significantly. The patients were in general euthyroid. One of them, on HDP for several years, developed clinical and laboratory signs indicative of hyperthyroidism. In a considerable proportion of the cases the results of the hormone studies (increased PTH, CT, cAMP) were consistent with secondary hyperparathyroidism. Kidney transplantation was followed by a decline of the serum prolactin, parathormone, calcitonin and aldosterone levels.