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[Endocrine abnormalities in patients with chronic renal failure - part II]

Robert Krysiak1, Agnieszka Kędzia1, Joanna Krupej-Kędzierska1

  • 1Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|June 4, 2015
PubMed

Insights

Chronic renal failure impairs kidney function, affecting hormone regulation and leading to endocrine disorders like abnormal adrenal and gonadal axes, bone loss, and gynecomastia.

Area of Science:

  • Nephrology
  • Endocrinology
  • Internal Medicine

Context:

  • Kidneys are vital for homeostasis, regulating fluids, electrolytes, acid-base balance, and volume.
  • Chronic renal failure (CRF) significantly impairs these homeostatic functions, especially in advanced stages.
  • Endocrine organ function is disrupted in CRF through various mechanisms.

Purpose:

  • To review the multifaceted endocrine disturbances associated with chronic renal failure.
  • To highlight the clinical relevance of these alterations in patients with kidney disease.
  • To discuss the impact of treatment strategies on the clinical presentation of these endocrine issues.

Summary:

  • CRF affects endocrine function via impaired secretion of kidney-derived hormones, altered hormone metabolism and binding, and abnormal target organ responsiveness.
  • Key endocrine dysfunctions in CRF include secondary hyperparathyroidism, thyroid dysfunction, impaired growth, abnormal hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes, bone loss, and gynecomastia.
  • The clinical manifestations and laboratory findings of these endocrine disturbances are influenced by the chosen treatment strategies.

Impact:

  • Provides a comprehensive overview of endocrine complications in chronic kidney disease patients.
  • Aids clinicians in recognizing and managing hormonal imbalances in renal failure.
  • Informs future research directions for addressing endocrine dysfunction in nephrology.
Keywords:
chronic renal diseasegynecomastiahypothalamic-pituitary-adrenal axishypothalamic-pituitary-gonadal axisosteoporosisrenin-angiotensin-aldosterone system

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