References on Sodium-Retaining Potency of Corticosteroids

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To the editor: There are two major reasons to measure accurately the mineralocorticoid potency of a corticosteroid preparation. First, a corticosteroid must be used for its anti-inflammatory effect without inducing excessive sodium retention that causes edema and congestive heart failure. Second, the choice of replacement therapy in a patient with primary adrenal insufficiency depends on the ratio of glucocorticoid to mineralocorticoid activity. A corticosteroid preparation with little or no sodium-retaining properties must often be supplemented with a more potent mineralocorticoid to prevent hyperkalemia, hypotension, or vascular collapse.

Comparison of the reported mineralocorticoid potencies of some widely used corticosteroids, as listed

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