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The Effect of Stress Hormones on Kidney Function

Exposure to any form of stress triggers activity within the hypothalamic-pituitary-adrenal axis. The key aspect of stress response is adrenal release of norepinephrine, epinephrine and cortisol. These hormones affect multiple physiological functions, including those of kidneys.

  1. Calcium Balance

    • In addition to reducing intestinal calcium absorption, cortisol inhibits calcium reabsorption from renal tubules, which results in calcium loss.

    Electrolyte And Fluid Regulation

    • Cortisol promotes phosphate excretion by the kidneys. At high enough concentrations, cortisol, like aldosterone, causes retention of sodium and fluid.

    Glomerular Filtration Rate

    • Catecholamines, i.e, epinephrine and norepinephrine, cause constriction of blood vessels within the kidney, which results in diminished glomerular filtration rate and, subsequently, reduced urinary water output.

    Sodium Retention

    • Catecholamines reduce kidney sodium excretion, further contributing to water retention.

    Implications

    • The combination of vasoconstriction and increase in blood volume (because of water retention) raises blood pressure, which can, over time, translate into chronic hypertension. Persistent water retention as an outcome of prolonged elevations in stress hormones can also produce edema.

    TCM Perspective

    • Traditional Chinese medicine (TCM) regards disturbances within the kidney organ, which encompasses the adrenals and the entire endocrine system, as particularly detrimental. Kidneys are viewed in TCM as the origin of Qi, or vital energy.

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