Several hormonal indices during hemofiltration in patients with acute kidney failure

AIM: To study hormonal aspects of hemofiltration (HF) in acute renal failure (ARF). MATERIAL AND METHODS: Hydrocortisone (HC), thyroxine (T4), triiodothyronine (T3), TSH, thyrocalcitonine (TC), PTH, insulin (I), C-peptide (CP), STH, beta-endorphine (BE) were examined for plasma content, elimination with filtrate, sifting rate, filtration clearance in 29 patients with oliguric ARF (18 males and 11 females) aged 12-62 years. 19 patients underwent intermittent HF (rate 145.2 +/- 9.2/27-260/ml/min, volume 1.02 +/- 0.20/0.45-1.43/). 10 patients received continuous HF (rate 25.9 +/- 2.3 l/day or 0.36 +/- 0.05/0.17-0.95/). The hormones were measured with radioimmunoassay. The results were processed with variate statistics using Student's criterium. RESULTS: Oliguria was associated with high plasma levels of HC, PTH, TC, I, CP; normal levels of TSH and STH, low ones of T4, T3 and BE. Intermittent HF led to an increased plasma concentrations of HC, T4, I, CP, decreased one of PTH, while TC, TSH, STH and T3 remained unchanged. The filtration rate of the hormones was different. The elimination was greatest for HC, T4, T3, BE. Concentration of the former three in the filtrate surpassed that in blood plasma. CONCLUSION: Besides intensive elimination of the hormones with low molecular mass (HC, T4, T3), HF causes elimination of appreciable quantities of BE, PTH, I, CT and, probably, other peptide hormones. Plasma levels of hormones did not reflect their elimination with filtrate.