The kidney plays an important role in synthesis, metabolism and elimination of a plethora of hormones. In subjects with chronic renal failure, particularly at its later stages, these adaptive responses are impaired and some of these alterations are of clinical relevance. Endocrine disturbances which are the most characteristic for chronic renal failure include: secondary and tertiary hyperparathyroidism, hypothalamic-pituitary-thyroid axis dysfunction and impaired growth. The pathogenesis of these complications is complex and multifactorial. This review discusses the most important changes in the function of the parathyroid glands, thyroid and the growth hormone-insulin-like growth factor 1 axis in the light of recent developments in this field. This article also tries to give insights into diagnosis and putative therapeutic strategies.
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