Effects of sudden discontinuation of hormones on kidney disease

  Patients who have been using glucocorticosteroids in large quantities for a long time may show signs of adrenocortical insufficiency if the drug is suddenly stopped, such as general malaise, listlessness, fatigue, lethargy, loss of appetite, nausea, weight loss, dizziness and postural hypotension. Even the adrenal wi-fi appears, see nausea, vomiting, abdominal pain, diarrhea, severe dehydration, reduced blood pressure, psychosis, hyperthermia, hypoglycemia and hyponatremia. If resuscitation is not timely, it may develop into shock and even death.  It takes 3-5 months for the pituitary gland to recover its ACTH secretion function after discontinuing hormones; it takes 6-9 months or more for the adrenal cortex to recover its function to respond to ACTH.  Therefore, hormones should be discontinued slowly. If necessary, the cortisol concentration in the body should be tested or an adrenocorticotropic hormone stimulation test should be performed, and if the adrenal cortex is functioning well, the hormones can be further withdrawn slowly.  Hormones cannot be stopped suddenly, as seen in the following cases: 1. those who have taken 20mg prednisone orally for more than 3 weeks; 2. those who take the drug only at night; 3. those who take hormones and have developed Cushing’s sign such as full moon face, buffalo back, thinning skin and acne; 4. those who have nephrotic syndrome repeatedly for many times and are hormone dependent.