Menstrual disturbances in chronic renal failure

Area of Science:

• Endocrinology
• Nephrology
• Reproductive Medicine

Background:

• Chronic kidney disease (CKD) and its treatments, such as hemodialysis (HD) and kidney transplantation (PT), can significantly impact hormonal balance and reproductive health in women.
• Previous research has primarily focused on the endocrine disturbances in uremic males, leaving a gap in understanding female-specific alterations.

Purpose of the Study:

• To investigate the hormonal profiles and reproductive disturbances in pre-dialysis and post-transplant female patients.
• To compare these findings with healthy controls and previously reported data from uremic males.

Main Methods:

• Studied 12 female patients on intermittent hemodialysis (HD) and 5 post-transplant (PT) females.
• Assessed menstrual disturbances, galactorrhea, basal and gonadotropin-releasing hormone (GnRH)-stimulated luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels.
• Measured serum levels of 17B estradiol, progesterone, testosterone, and prolactin.

Main Results:

• HD patients exhibited menstrual disturbances, galactorrhea, elevated basal LH, and significantly lower serum estradiol, progesterone, and testosterone compared to controls.
• Elevated prolactin levels in HD patients correlated with galactorrhea but not amenorrhea.
• PT patients showed an exaggerated LH response to GnRH at 120 minutes and only significantly lower testosterone levels.

Conclusions:

• Hemodialysis in women is associated with significant reproductive endocrine dysfunction, including hyperprolactinemia and hypogonadism, distinct from findings in uremic males.
• Kidney transplantation may partially normalize some hormonal parameters, but reproductive disturbances can persist.