Chronic kidney disease as a potential risk factor for pituitary hormone dysregulation: a review of the underlying mechanisms.

Chronic Kidney Disease (CKD) is a condition of abnormal kidney structure or function, pathologically characterized by chronic inflammation, tubular atrophy, vascular rarefaction, glomerulosclerosis, and interstitial fibrosis. CKD potentially represents a risk factor for several disease conditions, such as cardiovascular disease, mineral bone disorder, and electrolyte imbalance. Hormone dysregulation within the pituitary axis is yet another condition that CKD influences. Notably, CKD dysregulates several anterior pituitary hormones, either by directly influencing hypothalamic-pituitary secretion or by altering downstream hormones, which then dysregulate pituitary secretion via negative feedback. In the context of CKD-influenced hormone dysregulation, several contributors, including high uremic toxins, inflammatory cytokines, mineral imbalance, and dysregulated molecular mediators related to fibroblast growth factor 23-Klotho signaling, circulating microRNAs, the kidney-gut-brain axis, and glial and endothelial modulation, play integral roles. In conclusion, this review highlights the potential participation of CKD in pituitary dysregulation and provides insights into its potential contributors.