18-Hydroxycorticosterone that has a weak electrolyte action is a derivative of corticosterone. Corticosterone is converted into 18-hydroxycorticosterone by two steps, 18-hydroxylation and 18-oxidation. These two steps are catalyzed by CYP11B2. There is no difference between the sexes in the concentration of this steroid; however, ACTH stimulation increases the plasma concentration of 18-hydroxycorticosterone while dexamethasone decreases this steroid. Very little is known about the physiological function of this steroid. In adrenalectomized rats, 18-hydroxycorticosterone has a positive effect on the brush border Na+/K+ exchanger with the physiological concentration. In sodium-replete patients with low-renin essential hypertension, 18-hydroxycorticosterone seems to be a better marker than aldosterone.
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