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Disease-a-month : DM · Dec 2022
Endocrine manifestations of chronic kidney disease and their evolving management: A systematic review.
- Nirja Kaka, Yashendra Sethi, Neil Patel, Okashah Kaiwan, Yana Al-Inaya, Kshitij Manchanda, and Nidhi Uniyal.
- GMERS Medical College, Himmatnagar, Gujarat 382007, India.
- Dis Mon. 2022 Dec 1; 68 (12): 101466101466.
BackgroundChronic Kidney Disease (CKD) shows a wide range of renal abnormalities including the excretory, metabolic, endocrine, and homeostatic function of the kidney. The prognostic impact of the 'endocrine manifestations' which are often overlooked by clinicians cannot be overstated.Methods And ObjectivesA systematic review was attempted to provide a comprehensive overview of all endocrine abnormalities of CKD and their evolving principles of management, searching databases of PubMed, Embase, and Scopus and covering the literature between 2002 and 2022.ResultsThe endocrine derangements in CKD can be attributed to a myriad of pathologic processes, in particular decreased clearance, impaired endogenous hormone production, uremia-induced cellular dysfunction, and activation of systemic inflammatory pathways. The major disorders include anemia, hyperprolactinemia, insulin resistance, reproductive hormone deficiency, thyroid hormone deficiency, and serum FGF (Fibroblast Growth Factor) alteration. Long-term effects of CKD also include malnutrition and increased cardiovascular risk. The recent times have unveiled their detailed pathogenesis and have seen an evolution in the principles of management which necessitates a revision of current guidelines.ConclusionIncreased advertence regarding the pathology, impact, and management of these endocrine derangements can help in reducing morbidity as well as mortality in the CKD patients by allowing prompt individualized treatment. Moreover, with timely and appropriate intervention, a long-term reduction in complications, as well as an enhanced quality of life, can be achieved in patients with CKD.Copyright © 2022 Elsevier Inc. All rights reserved.
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