Abstract
The number of chronic hemodialysis patients with impaired activities of daily life (ADL) have increased because of long-term dialysis and old age. We encountered 2 dialysis patients with low ADL probably due to adrenal insufficiency between 2006 and 2008. Patient 1 was a 63-year-old male who was hospitalized due to intestinal obstruction in October 2006. After recovery from ileus. However, he complained of appetite loss and severe general fatigue. The baseline cortisol level was normal but ACTH increased up to 211 pg/mL, suggesting relative cortisol deficiency. Patient 2 was a 79-year-old female. In June 2007, she was hospitalized due to pneumonia and recovered after administration of antibiotics. However, appetite loss persisted. The baseline cortisol was normal but ACTH had increased by 100% of the normal range (103 pg/mL). These 2 patients were treated with hydrocortisone and their complaints improved within 2 weeks. In dialysis patients, typical symptoms of adrenal insufficiency, such as loss of sodium and dehydration, are not observed. These patients suggest that adrenal insufficiency is one of the causes of low ADL in hemodialysis patients.
