Pituitary dysfunctions in uremic patients undergoing peritoneal dialysis: a cross sectional descriptive study

Several hormonal alterations have been described in patients with chronic renal failure. However, there are few epidemiological studies on uremia-associated endocrine derangements, in particular in patients undergoing peritoneal dialysis (PD). A cross-sectional descriptive study was performed to assess the prevalence of hormonal dysfunctions affecting pituitary secretions in the whole population of patients in the PD unit of our hospital. The total population included 69 patients, 66 on continuous ambulatory PD and 3 on continuous cycling PD. There were 31 men and 38 women, the mean age was 55 years (range 23-82 years), and the mean duration of PD was 32 months (range 1-161 months). There were 27 (39.1%) patients with diabetes mellitus (7 type I and 20 type II). Clinical records were reviewed for hormonal alterations affecting the pituitary and its target glands. The whole population had available data on the pituitary-thyroid axis. The following diagnoses and prevalences were found: hypothyrotropic hypothyroidism 4 (5.8%), subclinical hypothyroidism 4 (5.8%), primary hypothyroidism 8 (11.6%), and low T3 syndrome 11 (15.9%). The remaining pituitary hormones were available in 20 patients. Hyperprolactinemia was found in 7 (35%) patients and abnormally increased growth hormone levels in 6 (30%). Gonadotropin levels were normal for the age of the women and showed a tendency to be increased in most of the men. Corticotropin levels were normal in all patients with available data. There was no relationship between the high prevalence of diabetes mellitus in our population and the remaining hormonal derangements found. These results suggest that there is a non-negligible prevalence of pituitary abnormalities in uremic patients undergoing PD.