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Macroprolactin does not contribute to elevated levels of prolactin in patients on renal replacement therapy

Dilek Yavuz1, Güler Topçu, Cetin Ozener

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.

Clinical Endocrinology
|November 5, 2005
PubMed
Abstract

Insights

Hyperprolactinemia in chronic renal failure (CRF) is not due to macroprolactin but a decline in kidney function. This impacts prolactin (PRL) levels in patients undergoing renal replacement therapy.

Area of Science:

  • Endocrinology
  • Nephrology

Background:

  • Prolactin (PRL) exists in multiple molecular forms, including macroprolactin.
  • Kidneys play a role in PRL clearance, and reduced function in chronic renal failure (CRF) can lead to hyperprolactinemia.
  • Macroprolactin can interfere with immunoassay results, complicating the assessment of PRL levels in CRF.

Purpose of the Study:

  • To investigate the contribution of macroprolactin isoforms to elevated prolactin (PRL) levels in patients with chronic renal failure (CRF).
  • To differentiate the causes of hyperprolactinemia in patients undergoing various renal replacement therapies.

Main Methods:

  • Serum PRL levels were measured in 91 patients on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), and renal transplantation (RT), alongside 72 controls.
  • Macroprolactin isoforms were identified by polyethylene glycol (PEG) precipitation and calculating recovery ratios; samples with <50% recovery indicated macroprolactin presence.

Main Results:

  • CRF patients exhibited significantly higher serum and supernatant PRL levels compared to controls (P < 0.001).
  • PRL levels were significantly higher in HD and CAPD patients than in RT patients (P < 0.001).
  • A moderate correlation was observed between PRL and creatinine levels (r = 0.609, P < 0.001).

Conclusions:

  • Hyperprolactinemia in patients undergoing renal replacement therapy is primarily linked to diminished renal function, not macroprolactin isoforms.
  • The findings suggest that reduced kidney function directly impacts prolactin clearance and contributes to elevated PRL levels in CRF.

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