Algorithm for Screening of Adrenal Function in Stable Patients with Cirrhosis

Abstract

Introduction and aims: Adrenal insufficiency (AI) is common in patients with cirrhosis. We aimed to assess the presence of AI in stable patients with cirrhosis using the gold-standard insulin tolerance test (ITT) and to propose an algorithm for screening AI in these patients. Material and methods: We studied 40 stable patients with cirrhosis. We determined the basal total (BTC) and peak cortisol (PTC) levels. Using the ITT, we defined AI as a serum PTC 9 or MELD >12). Conclusion: An algorithm including the use of BTC and the severity of liver disease may be a useful and simple method for assessing adrenal function in stable patients with cirrhosis.

Keywords

• Adrenal insufficiency
• Hepato-adrenal syndrome
• Liver cirrosis
• Insulin tolerance test
• Cortisol