problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13212problendo-13212Research ArticleКлиническая эндокринологияClinical endocrinologyНарушения функции гипофиза у пациентов с терминальной стадией хронической почечной недостаточностиPituitary disorders in patients with end-stage chronic renal failurehttps://orcid.org/0000-0002-8798-887XМарковаТ. Н.MarkovaT. N.

Маркова Татьяна Николаевна - д.м.н., профессор.

123182, Москва, ул. Пехотная, д. 3

Tatyana N. Markova - MD, PhD, Professor.

3 Pehotnaja street, 123182 Moscow

markovatn18@yandex.ruhttps://orcid.org/0000-0003-4732-6748КосоваЕ. В.KosovaE. V.

Косова Екатерина Валерьевна

Москва

Ekaterina V. Kosova, MD.

Moscow

dok_kosova@bk.ruhttps://orcid.org/0000-0001-8270-5626МищенкоН. К.MishchenkoN. K.

Мищенко Надежда Константиновна

Балашиха

Nadezhda K. Mishchenko - PhD student, endocrinologist.

Balashikha

koc-nadushka@yandex.ruМосковский государственный медико-стоматологический университет им. А.И. Евдокимова; Городская клиническая больница № 52 ДЗМРоссияMoscow State University of Medicine and Dentistry Named after A.I.Evdokimov; City Clinical Hospital №52Russian FederationМосковский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияMoscow State University of Medicine and Dentistry Named after A.I.EvdokimovRussian FederationООО «Мед Гарант»РоссияMedical Center «Med Garant»Russian Federation2023240120246963746Copyright © Маркова Т.Н., Косова Е.В., Мищенко Н.К., 20242024Маркова Т.Н., Косова Е.В., Мищенко Н.К.Markova T.N., Kosova E.V., Mishchenko N.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/13212

Патологические изменения в работе почек приводят к нарушению поддержания гомеостаза внутренней среды организма. По мере снижения скорости клубочковой фильтрации и нарастания уремии уменьшается метаболизм, изменяются процессы транспортировки и связывания с клетками-мишенями многочисленных биологически активных веществ, в том числе гормонов гипофиза. В статье представлен обзор нарушений функции гипофиза у пациентов с терминальной стадией хронической болезни почек (тХБП) и обсуждены патогенетические механизмы их формирования. Особое внимание уделено оценке изменений концентрации гормонов гипофиза у пациентов, получающих заместительную почечную терапию (ЗПТ). Так, тХБП приводит к повышению уровня пролактина, лютеинизирующего гормона (ЛГ) и фолликулостимулирующего гормона (ФСГ). Концентрации соматотропного гормона (СТГ), инсулиноподобного фактора роста-1 (ИФР-1), тиреотропного гормона (ТТГ), адренокортикотропного гормона (АКТГ) и вазопрессина могут оставаться в пределах нормальных значений или повышаться в данной группе больных. Проведение ЗПТ не снижает уровни пролактина, ЛГ, ФСГ, в то же время концентрации СТГ, ИФР-1, ТТГ имеют тенденцию к нормализации. Содержание АКТГ и вазопрессина может оставаться без изменений или уменьшаться. Трансплантация почки в большинстве случаев корректирует описанные нарушения. В целом устранение гормональных изменений способно улучшить клинический исход и качество жизни пациентов, страдающих тХБП.

Disorders in the kidneys lead to disturbance of homeostasis. As the glomerular filtration rate decreases, the metabolism of numerous biologically active substances, including pituitary hormones, decreases. The article presents an overview of pituitary dysfunction in patients with chronic kidney disease (CKD) and discusses the possible reasons of the pathogenetic mechanisms. Particular focus is being given to the assessment of changes in the concentration of pituitary hormones in patients with end-stage chronic kidney disease (CKD) and discusses the pathogenetic mechanisms of their formation. Particular attention is paid to the assessment of changes in the concentration of pituitary hormones in patients receiving renal replacement therapy (RRT). CKD leads to an increase in the level of prolactin, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Concentrations of growth hormone (GH), isulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH) and vasopressin may remain within normal values or increase in this group of patients. RRT does not reduce the levels of prolactin, LH, FSH, while the concentration of growth hormone, IGF-1, TSH tends to normalize. The content of ACTH and vasopressin may remain unchanged or decrease. Kidney transplantation in most cases corrects hormonal disorders. Correction of hormonal changes can improve the clinical outcome and quality of life of patients with end stage CKD.

гипофизгормоныхроническая болезнь почекгемодиализперитонеальный диализтрансплантация почкиpituitaryhormoneschronic kidney diseasehemodialysisperitoneal dialysiskidney transplantationРабота выполнена по инициативе авторов без привлечения финансирования.Smirnov A.V., Shilov E.M., Dobronravov V.A., i dr. Natsional'nye rekomendatsii. Khronicheskaya bolezn' pochek: osnovnye printsipy skrininga, diagnostiki, profilaktiki i podkhody k lecheniyu // Nefrologiya. — 2012. — T. 16. — №1. — S. 89-115. doi: https://doi.org/10.24884/1561-6274-2012-16-1-89-115Hill Nathan R. Fatoba Samuel T. Oke Jason L. Hirst Jennifer A. O’Callaghan Christopher A. Lasserson Daniel S. Hobbs F. D. Richard Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis PLOS ONE 2016 07 e0158765 11 7 10.1371/journal.pone.0158765Foreman Kyle J Marquez Neal Dolgert Andrew Fukutaki Kai Fullman Nancy McGaughey Madeline Pletcher Martin A Smith Amanda E Tang Kendrick Yuan Chun-Wei Brown Jonathan C Friedman Joseph He Jiawei Heuton Kyle R Holmberg Mollie Patel Disha J Reidy Patrick Carter Austin Cercy Kelly Chapin Abigail Douwes-Schultz Dirk Frank Tahvi Goettsch Falko Liu Patrick Y Nandakumar Vishnu Reitsma Marissa B Reuter Vince Sadat Nafis Sorensen Reed J D Srinivasan Vinay Updike Rachel L York Hunter Lopez Alan D Lozano Rafael Lim Stephen S Mokdad Ali H Vollset Stein Emil Murray Christopher J L Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories The Lancet 2018 10 2052 2090 392 10159 10.1016/s0140-6736(18)31694-5Khronicheskaya bolezn' pochek: uchebnoe posobie / Pod red. Nikitin I.G., Reznik E.V., Zaivaya M.V., i dr. — M.: RNIMU im.N.I.Pirogova Minzdrava Rossii; 2019.Niemczyk S, Niemczyk L, Romejko-Ciepielewska K. Basic endocrinological disorders in chronic renal failure. Endokrynol Pol. 2012;63(3):250-257.Brinkman JE, Tariq MA, Leavitt L, et al. Physiology, Growth Hormone. [Updated 2021 May 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 05.11.2011]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482141/Haffner D, Grund A, Leifheit-Nestler M. Renal effects of growth hormone in health and in kidney disease. Pediatr Nephrol. 2021;36(8):2511-2530. doi: https://doi.org/10.1007/s00467-021-05097-6.Mahesh Shefali Kaskel Frederick Growth hormone axis in chronic kidney disease Pediatric Nephrology 2007 08 41 48 23 1 10.1007/s00467-007-0527-xGurevich Evgenia Segev Yael Landau Daniel Growth Hormone and IGF1 Actions in Kidney Development and Function Cells 2021 12 3371 10 12 10.3390/cells10123371Ikizler TA, Cano NJ, Franch H, et al. International Society of Renal Nutrition and Metabolism. Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84(6):1096-1107. doi: https://doi.org/10.1038/ki.2013.147Kopple J. D. Cheung A. K. Christiansen J. S. Djurhuus C. B. El Nahas M. Feldt-Rasmussen B. Mitch W. E. Wanner C. Gothberg M. Ikizler T. A. OPPORTUNITY : a large-scale randomized clinical trial of growth hormone in hemodialysis patients Nephrology Dialysis Transplantation 2011 07 4095 4103 26 12 10.1093/ndt/gfr363Al-Chalabi M, Bass AN, Alsalman I. Physiology, Prolactin. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507829/Edey Matthew M. Male Sexual Dysfunction and Chronic Kidney Disease Frontiers in Medicine 2017 03 4 10.3389/fmed.2017.00032Ognivenko V.M. Biokhimiya gormonov. Uchebnoe posobie dlya samostoyatel'noi raboty po biokhimii studentov meditsinskikh vuzov / Pod red. Vavilovoi T.P. M.: Izd. MGMSU; 2008.Brin V.B., Tabolova L.S., Salbiev K.D., i dr. K voprosu o roli prolaktina v regulyatsii vodno-solevogo obmena // Nefrologiya. — 2001. — T. 5. — №3. — S. 93-94.Rojas-Vega Lorena Reyes-Castro Luis A. Ramírez Victoria Bautista-Pérez Rocío Rafael Chloe Castañeda-Bueno María Meade Patricia de los Heros Paola Arroyo-Garza Isidora Bernard Valérie Binart Nadine Bobadilla Norma A. Hadchouel Juliette Zambrano Elena Gamba Gerardo Ovarian hormones and prolactin increase renal NaCl cotransporter phosphorylation American Journal of Physiology-Renal Physiology 2015 01 F799 F808 308 8 10.1152/ajprenal.00447.2014Lo Joan C. Beck Gerald J. Kaysen George A. Chan Christopher T. Kliger Alan S. Rocco Michael V. Chertow Glenn M. Hyperprolactinemia in end‐stage renal disease and effects of frequent hemodialysis Hemodialysis International 2016 10 190 196 21 2 10.1111/hdi.12489Lo Joan C. Beck Gerald J. Kaysen George A. Chan Christopher T. Kliger Alan S. Rocco Michael V. Chertow Glenn M. Hyperprolactinemia in end‐stage renal disease and effects of frequent hemodialysis Hemodialysis International 2016 10 190 196 21 2 10.1111/hdi.12489SIEVERTSEN GRANT D. LIM VICTORIA S. NAKAWATASE CHARLOTTE FROHMAN LAWRENCE A. Metabolic Clearance and Secretion Rates of Human Prolactin in Normal Subjects and in Patients with Chronic Renal Failure* The Journal of Clinical Endocrinology & Metabolism 2009 07 846 852 50 5 10.1210/jcem-50-5-846Adachi Naoto Lei Baiping Deshpande Gautam Seyfried Frank J. Shimizu Ichiro Nagaro Takumi Arai Tatsuru Uraemia suppresses central dopaminergic metabolism and impairs motor activity in rats Intensive Care Medicine 2002 10 1655 1660 27 10 10.1007/s001340101067Kovacs C S Chik C L Hyperprolactinemia caused by lactation and pituitary adenomas is associated with altered serum calcium, phosphate, parathyroid hormone (PTH), and PTH-related peptide levels. The Journal of Clinical Endocrinology & Metabolism 2014 01 3036 3042 80 10 10.1210/jcem.80.10.7559893Dourado Marclébio Cavalcanti Frederico Vilar Lucio Cantilino Amaury Relationship between Prolactin, Chronic Kidney Disease, and Cardiovascular Risk International Journal of Endocrinology 2020 06 1 6 2020 10.1155/2020/9524839Carrero Juan Jesús Kyriazis John Sonmez Alper Tzanakis Ioannis Qureshi Abdul Rashid Stenvinkel Peter Saglam Mutlu Stylianou Kostas Yaman Halil Taslipinar Abdullah Vural Abdulgaffar Gok Mahmut Yenicesu Mujdat Daphnis Eugene Yilmaz Mahmut Ilker Prolactin Levels, Endothelial Dysfunction, and the Risk of Cardiovascular Events and Mortality in Patients with CKD Clinical Journal of the American Society of Nephrology 2011 12 207 215 7 2 10.2215/cjn.06840711Markova T.N., Kosova E.V., Sinyavkin D.O. i dr. Rol' dializnykh metodov lecheniya v formirovanii sindroma giperprolaktinemii. V kn.: Sbornik tezisov VIII (XXVI) Natsional'nogo kongressa endokrinologov «Personalizirovannaya meditsina i prakticheskoe zdravookhranenie» — M.: UP Print; 2019. S. 364-365.Kumar Rajesh Jhorawat Rajesh Mathur Mohit Garsa Rajesh Kumar Kimmatkar Piyush Deepak Sharma Sanjeev Singh Ajaypal Beniwal Pankaj Malhotra Vinay Effect of renal transplantation on multiple hormone levels in patients of chronic kidney disease: A single center study Indian Journal of Transplantation 2014 09 75 79 8 3 10.1016/j.ijt.2014.08.002Nedresky D, Singh G. Physiology, Luteinizing Hormone. [Updated 2021 Sep 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 06.11.2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539692/Orlowski M, Sarao MS. Physiology, Follicle Stimulating Hormone. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 06.11.2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535442/Kuczera Piotr Adamczak Marcin Wiecek Andrzej Endocrine Abnormalities in Patients with Chronic Kidney Disease PRILOZI 2016 01 109 118 36 2 10.1515/prilozi-2015-0059Schmidt Alice Luger Anton Hörl Walter H. Sexual hormone abnormalities in male patients with renal failure Nephrology Dialysis Transplantation 2002 07 368 371 17 3 10.1093/ndt/17.3.368Edey Matthew M. Male Sexual Dysfunction and Chronic Kidney Disease Frontiers in Medicine 2017 03 4 10.3389/fmed.2017.00032Salvadori Maurizio Tsalouchos Aris Fertility and Pregnancy in End Stage Kidney Failure Patients and after Renal Transplantation: An Update Transplantology 2021 04 92 108 2 2 10.3390/transplantology2020010Farahmand Maryam Ramezani Tehrani Fahimeh Khalili Davood Cheraghi Leila Azizi Fereidoun Endogenous estrogen exposure and chronic kidney disease; a 15-year prospective cohort study BMC Endocrine Disorders 2021 08 21 1 10.1186/s12902-021-00817-3Ma Hao-Yang Chen Shuang Du Yang Estrogen and estrogen receptors in kidney diseases Renal Failure 2021 03 619 642 43 1 10.1080/0886022x.2021.1901739Filler Guido Ramsaroop Amanda Stein Robert Grant Claire Marants Raanan So Aaron McIntyre Christopher Is Testosterone Detrimental to Renal Function? Kidney International Reports 2016 07 306 310 1 4 10.1016/j.ekir.2016.07.004Doublier Sophie Lupia Enrico Catanuto Paola Periera-Simon Simone Xia Xiaomei Korach Ken Berho Mariana Elliot Sharon J. Karl Michael Testosterone and 17β-estradiol have opposite effects on podocyte apoptosis that precedes glomerulosclerosis in female estrogen receptor knockout mice Kidney International 2010 10 404 413 79 4 10.1038/ki.2010.398Lu Yan Fu Yiling Ge Ying Juncos Luis A. Reckelhoff Jane F. Liu Ruisheng The Vasodilatory Effect of Testosterone on Renal Afferent Arterioles Gender Medicine 2012 03 103 111 9 2 10.1016/j.genm.2012.02.003Filler Guido Ramsaroop Amanda Stein Robert Grant Claire Marants Raanan So Aaron McIntyre Christopher Is Testosterone Detrimental to Renal Function? Kidney International Reports 2016 07 306 310 1 4 10.1016/j.ekir.2016.07.004Sikora-Grabka E, Adamczak M, Kuczera P et al. Serum sex hormones concentrations in young women in the early period after successful kidney transplantation. Endokrynologia Polska. 2018;69(2):150-155. doi: https://doi.org/10.5603/EP.2018.0019xReinhardt W. Kübber H. Dolff S. Benson S. Führer D. Tan S. Rapid recovery of hypogonadism in male patients with end stage renal disease after renal transplantation Endocrine 2018 02 159 166 60 1 10.1007/s12020-018-1543-2Ząbczyńska Marta Kozłowska Kamila Pocheć Ewa Glycosylation in the Thyroid Gland: Vital Aspects of Glycoprotein Function in Thyrocyte Physiology and Thyroid Disorders International Journal of Molecular Sciences 2018 09 2792 19 9 10.3390/ijms19092792Mohamedali Mohamed Reddy Maddika Srikanth Vyas Anix Iyer Viswanathan Cheriyath Pramil Thyroid Disorders and Chronic Kidney Disease International Journal of Nephrology 2014 04 1 6 2014 10.1155/2014/520281Schairer Benjamin Jungreithmayr Viktoria Schuster Mario Reiter Thomas Herkner Harald Gessl Alois Sengölge Gürkan Winnicki Wolfgang Effect of Thyroid Hormones on Kidney Function in Patients after Kidney Transplantation Scientific Reports 2020 02 10 1 10.1038/s41598-020-59178-xBasu Gopal Mohapatra Anjali Interactions between thyroid disorders and kidney disease Indian Journal of Endocrinology and Metabolism 2012 03 204 16 2 10.4103/2230-8210.93737Rhee Connie M. Thyroid disease in end-stage renal disease Current Opinion in Nephrology and Hypertension 2019 09 621 630 28 6 10.1097/mnh.0000000000000542Carrero J. J. Qureshi A. R. Axelsson J. Yilmaz M. I. Rehnmark S. Witt M. R. Bárány P. Heimbürger O. Suliman M. E. Alvestrand A. Lindholm B. Stenvinkel P. Clinical and biochemical implications of low thyroid hormone levels (total and free forms) in euthyroid patients with chronic kidney disease Journal of Internal Medicine 2007 10 690 701 262 6 10.1111/j.1365-2796.2007.01865.xOzen Kezban Pinar Asci Gulay Gungor Ozkan Carrero Juan Jesus Kircelli Fatih Tatar Erhan Sevinc Ok Ebru Ozkahya Mehmet Toz Huseyin Cirit Mustafa Basci Ali Ok Ercan Nutritional State Alters the Association between Free Triiodothyronine Levels and Mortality in Hemodialysis Patients American Journal of Nephrology 2011 03 305 312 33 4 10.1159/000324883Fernández-Reyes M.J. Diez J.J. Collado A. Iglesias P. Bajo M.A. Estrada P. Peso G. del Heras M. Molina A. Selgas R. Are low concentrations of serum triiodothyronine a good marker for long-term mortality in hemodialysis patients? Clinical Nephrology 2011 03 238 240 73 03 10.5414/cnp73238Chonchol Michel Lippi Giuseppe Salvagno Gianluca Zoppini Giacomo Muggeo Michele Targher Giovanni Prevalence of Subclinical Hypothyroidism in Patients with Chronic Kidney Disease Clinical Journal of the American Society of Nephrology 2008 06 1296 1300 3 5 10.2215/cjn.00800208Ghaddhab Chiraz Vuissoz Jean-Marc Deladoëy Johnny From Bioinactive ACTH to ACTH Antagonist: The Clinical Perspective Frontiers in Endocrinology 2017 02 8 10.3389/fendo.2017.00017MANGOS George J WHITWORTH Judith A WILLIAMSON Paula M KELLY John J Glucocorticoids and the kidney Nephrology 2003 12 267 273 8 6 10.1111/j.1440-1797.2003.00215.xBomback AS, Radhakrishnan J. Treatment of nephrotic syndrome with adrenocorticotropic hormone (ACTH). Discov Med. 2011;12(63):91-96.Gracia-Iguacel Carolina González-Parra Emilio Egido Jesús Lindholm Bengt Mahillo Ignacio Carrero Juan Jesús Ortiz Alberto Cortisol levels are associated with mortality risk in hemodialysis patients Clinical Nephrology 2014 09 247 256 82 (2014) 10 10.5414/cn108311Anwar Siddiq Larson Derek S. Naimi Nima Ashraf Muhammad Culiberk Nancy Liapis Helen Wei Changli Reiser Jochen Brennan Daniel C. A Case Report of Adrenocorticotropic Hormone to Treat Recurrent Focal Segmental Glomerular Sclerosis Post-Transplantation and Biomarker Monitoring Frontiers in Medicine 2015 03 2 10.3389/fmed.2015.00013Glavaš Mladena Gitlin-Domagalska Agata Dębowski Dawid Ptaszyńska Natalia Łęgowska Anna Rolka Krzysztof Vasopressin and Its Analogues: From Natural Hormones to Multitasking Peptides International Journal of Molecular Sciences 2022 03 3068 23 6 10.3390/ijms23063068Meijer E. Boertien W.E. Zietse R. Gansevoort R.T. Potential Deleterious Effects of Vasopressin in Chronic Kidney Disease and Particularly Autosomal Dominant Polycystic Kidney Disease Kidney and Blood Pressure Research 2011 06 235 244 34 4 10.1159/000326902Meijer Esther Bakker Stephan J.L. Halbesma Nynke de Jong Paul E. Struck Joachim Gansevoort Ron T. Copeptin, a surrogate marker of vasopressin, is associated with microalbuminuria in a large population cohort Kidney International 2009 10 29 36 77 1 10.1038/ki.2009.397Roussel Ronan Matallah Nadia Bouby Nadine El Boustany Ray Potier Louis Fumeron Frédéric Mohammedi Kamel Balkau Beverley Marre Michel Bankir Lise Velho Gilberto Plasma Copeptin and Decline in Renal Function in a Cohort from the Community: The Prospective D.E.S.I.R. Study American Journal of Nephrology 2015 09 107 114 42 2 10.1159/000439061Rho Mira Perazella Mark A. Parikh Chirag R. Peixoto Aldo J. Brewster Ursula C. Serum Vasopressin Response in Patients With Intradialytic Hypotension Clinical Journal of the American Society of Nephrology 2008 02 729 735 3 3 10.2215/cjn.05341107Meijer Esther Bakker Stephan J. L. de Jong Paul E. Homan van der Heide Jaap J. van Son Willem J. Struck Joachim Lems Simon P. M. Gansevoort Ron T. Copeptin, a Surrogate Marker of Vasopressin, Is Associated With Accelerated Renal Function Decline in Renal Transplant Recipients Transplantation 2009 08 561 567 88 4 10.1097/tp.0b013e3181b11ae4

The authors declare that there are no conflicts of interest present.