The effect of hemodialysis on the plasma concentration of β-endorphin (β-EP) and βw-lipotropin (β-LPH) was studied in 11 patients with end-stage renal disease (ESRD). The plasma β-EP/β-LPH concentrations measured at 13.00 h were not significantly different in the patients compared to age-matched controls. Furthermore, hemodialysis produced no change in the plasma concentrations of β-EP/β-LPH. The elevated levels of β-EP/LPH previously reported are most likely a reflection of the measurement of these peptides at a time of peak diurnal secretion compounded by a fall in the metabolic clearance rate of the endogenous opioids in ESRD. It remains to be established whether measurement of adronocorticotropic hormone or β-EP/β-LPH is more accurate an indicator of the integrity of the hypothalamic-pituitary-adrenal axis in patients with ESRD.

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