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[Pituitary disorders in patients with end-stage chronic renal failure]

T N Markova1, E V Kosova2, N K Mishchenko3

  • 1Moscow State University of Medicine and Dentistry Named after A.I.Evdokimov; City Clinical Hospital №52.

Problemy Endokrinologii
|February 5, 2024
PubMed

Insights

Chronic kidney disease (CKD) disrupts pituitary hormone levels, increasing prolactin, LH, and FSH. Renal replacement therapy may normalize some hormones, while kidney transplantation often corrects these endocrine dysfunctions, improving patient outcomes.

Area of Science:

  • Endocrinology
  • Nephrology
  • Homeostasis

Context:

  • Chronic kidney disease (CKD) significantly impacts homeostasis due to decreased glomerular filtration rate.
  • This reduction impairs the metabolism of various biologically active substances, including pituitary hormones.
  • Understanding these alterations is crucial for managing patients with kidney disorders.

Purpose:

  • To provide an overview of pituitary dysfunction in patients with CKD.
  • To discuss the pathogenetic mechanisms underlying these hormonal changes.
  • To assess pituitary hormone concentration changes in end-stage CKD and those undergoing renal replacement therapy (RRT).

Summary:

  • CKD elevates prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
  • Growth hormone (GH), IGF-1, TSH, ACTH, and vasopressin levels may be normal or increased.
  • RRT partially normalizes GH, IGF-1, and TSH, but not prolactin, LH, or FSH. Kidney transplantation generally corrects these hormonal imbalances.

Impact:

  • Hormonal corrections in CKD patients can enhance clinical outcomes.
  • Improved hormonal balance may lead to a better quality of life for patients with end-stage CKD.
  • Highlights the importance of monitoring and managing endocrine function in renal disease.

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