Endocrine disorders and diabetes mellitus in patients on hemodialysis

Abstract

The kidney plays an essential role in producing and metabolizing many hormones. Therefore, uremia is accompanied by significant endocrine changes. End-stage renal disease (ESRD) is a significant health problem due to the increased risk of morbidity and mortality. Hemodialysis (HD) provides essential support for restoring kidney functions in these patients. While fluid-electrolyte and acid-base imbalances in the body are controlled with HD treatment, which is life-saving in clinical practice, some endocrinological, physical, psychological, and social disorders may occur in these patients. The endocrine system may be affected by underlying diseases, and managing existing endocrine diseases may be complicated. Disorders in the hypothalamic-pituitary-gonadal axis and changes in the synthesis and clearance levels of many hormones may be observed. Hormonal disorders, especially those caused by kidney failure, can negatively affect endocrine organs such as the parathyroid, thyroid, adrenal glands, pituitary, gonads, and pancreas. In this chapter, endocrine diseases frequently seen in patients on HD and current information on the diagnosis and management of these diseases will be discussed.