biostudies-literatureSagmeister MSVersus ArthritisMedical Research CouncilNational Institute for Health Research (NIHR)Wellcome Trust241-249https://www.ebi.ac.uk/biostudies/studies/S-EPMC6334281biostudies-literatureUnknown90(1)<h4>Objective</h4>Patients with chronic kidney disease (CKD) have dysregulated cortisol metabolism secondary to changes in 11β-hydroxysteroid dehydrogenase (11β-HSD) enzymes. The determinants of this and its clinical implications are poorly defined.<h4>Methods</h4>We performed a cross-sectional study to characterize shifts in cortisol metabolism in relation to renal function, inflammation and glycaemic control. Systemic activation of cortisol by 11β-HSD was measured as the metabolite ratio (tetrahydrocortisol [THF]+5α-tetrahydrocortisol [5αTHF])/tetrahydrocortisone (THE) in urine.<h4>Results</h4>The cohort included 342 participants with a median age of 63 years, median estimated glomerular filtration rate (eGFR) of 28 mL/min/1.73 m² and median urine albumin-creatinine ratio of 3Clinical endocrinologyGlucocorticoid activation by 11β-hydroxysteroid dehydrogenase enzymes in relation to inflammation and glycaemic control in chronic kidney disease: A cross-sectional study.PMC6334281ACF-2015-09-0023536CL-2018-09-002105479/Z/14/ZMR/P021220/120843Sagmeister MSHardy RSNightingale PGHarper LArlt WCockwell PTaylor AEFenton AChanouzas DWall NAFerro CJfalseGlucocorticoid activation by 11β-hydroxysteroid dehydrogenase enzymes in relation to inflammation and glycaemic control in chronic kidney disease: A cross-sectional study.<h4>Objective</h4>Patients with chronic kidney disease (CKD) have dysregulated cortisol metabolism secondary to changes in 11β-hydroxysteroid dehydrogenase (11β-HSD) enzymes. The determinants of this and its clinical implications are poorly defined.<h4>Methods</h4>We performed a cross-sectional study to characterize shifts in cortisol metabolism in relation to renal function, inflammation and glycaemic control. Systemic activation of cortisol by 11β-HSD was measured as the metabolite ratio (tetrahydrocortisol [THF]+5α-tetrahydrocortisol [5αTHF])/tetrahydrocortisone (THE) in urine.<h4>Results</h4>The cohort included 342 participants with a median age of 63 years, median estimated glomerular filtration rate (eGFR) of 28 mL/min/1.73 m² and median urine albumin-creatinine ratio of 32019-01-01T00:00:00Z2019 Jan2026-06-04T09:47:05.495Z2025-05-18T11:31:12.316ZS-EPMC63342813035890310.1111/cen.13889