ON THE 17-HYDROXYCORTICOSTEROID CONTENT IN THE PLASMA AND ITS DAILY RHYTHM IN RENAL INSUFFICIENCY

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Abstract
The diurnal rhythm of total, conjugated and free 17-OHCS in the plasma was followed in 50 patients with renal insufficiency by taking blood specimens at 8 p.m. and the following morning at 8 a.m. The total 17-OHCS content of the morning urine sample averaged 93.9 [mu]g%-This was considerably above the normal, 40 [mu]g%- The conjugated 17-OHCS formed approximately 3/4 (73.6%) of the total 17-OHCS morning content. The average concentration of conjugated 17-OHCS was 69.0 [mu]g%, over 3 times the normal value, 20 [mu]g%. The free 17-OHCS content of 24.9 [mu]g% was somewhat higher than the normal, 20 [mu]g%. The total 17-OHCS content of the evening urine averaged 71.2 [mu]g%, which was more than 5 times the normal, 20 [mu]g%- The conjugated 17-OHCS was approximately 3/4 (76.1%) of the total evening 17-OHCS content in renal patients. The average evening content of free 17-OHCS was 18.0 [mu]g% significantly above the normal, 10 [mu]g%. The correlations between the morning and evening content of conjugated 17-OHCS as well as the evening content of free 17-OHCS, and the content of non-protein nitrogen phenosulphonphthalein excretion and the specific gravity of the morning urine were highly significant. When the non-protein nitrogen was increased above 40 mg%, the average morning content of total 17-OHCS was 148.7 [mu]g% and the average evening content 117.1 [mu]g%. When the phenosulphonphthalein excretion or the specific gravity of the morning urine was decreased, the morning and evening content of the conjugated 17-OHCS in the plasma as well as the evening concentration of the free 17-OHCS were also considerably higher than in normal kidney function. There was no correlation between the 17-OHCS in the plasma and anemia, or with increased blood pressure in renal disease.