Dynamic Change In Plasma Cortisol, Corticotrophin And Aldostrone After Kidney Or Adrenal Gland Surgery

Objective: To investigate the regular dynamic patterns of plasma cortisol, aldosterone, ACTH after kidney or adrenal gland surgery. And another target is to know about the incidence of postoperative adrenal insufficiency. Methods: We collected 80 cases of kidney or adrenal gland surgerys from Mar, 2005 to Dec, 2005 prospectively. The plasma cortisol, ACTH and aldosterone level were measured on the 2^nd day after admission, the 1^st, 3^rd and 6^th day after sugery. Result: On the 1^st day after surgery, the plasma cortisol concentration was markedly elevated; the plasma ACTH level declined to the lowest level, and the plasma aldosterone level showed a little decline trend, and all of three hormones returned to its normal baseline on the 6^th day after sugery. The incidence of adrenal insufficiency after total adrenal gland excision surgery was 50%; of partial adrenalectomy was 37.5%; and of surgery incorrelated to adrenal gland was 7.1%.There were 2 cases of symptomatic adrenal insufficiency. Conclusion: The phenomenon of dissociation between plasma cortisol and ACTH was found. Postoperative adrenal insufficiency prevention is important and it is necessary to need a further study.