[Regulation of aldosterone secretion in patients with thyrotoxicosis. I. Role of the renin-angiotensin system and corticotropin in the development of secondary hyperaldosteronism in patients with thyrotoxicosis].

The response of the adrenocortical glomerular zones to different aldosterone-stimulating and aldosterone-inhibiting effects was analyzed in 178 patients with pronounced thyrotoxicosis. Basal indices of aldosteronemia in the patients under examination did not differ from those of the controls, whereas the plasma renin activity, hormone and its 3-hydroxy metabolite excretion with the urine significantly increased. Obsidan blocked renin secretion and lowered the blood plasma aldosterone content. Prednisolone, dexamethasone and hydrocortisone, inhibiting adrenocorticotropic function, hindered aldosterone secretion, whereas injections of a synthetic ACTH analog synacten and insulin, mobilizing the hypothalamic-hypophyseal-adrenocortical system, markedly enhanced the blood plasma aldosterone level. Therefore, the response to the drugs, activating and blocking aldosterone secretion in patients with thyrotoxicosis, was completely adequate and sometimes even more intensified. Further investigation of causes, inducing an increase in the activity of the renin-angiotensin system in thyrotoxicosis, is necessary. Studies of the factors, capable of influencing aldosterone secretion, are in progress.