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Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician

While chronic kidney disease-associated mineral and bone disorders (CKD-MBD) prevail in the endocrinological assessment of CKD patients, other endocrine abnormalities are usually overlooked. CKD is associated with significant thyroid, adrenal and gonadal dysfunction, while persistent and de novo end...

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Autores principales: Bilha, Stefana Catalina, Hogas, Simona, Hogas, Mihai, Marcu, Stefan, Leustean, Letitia, Ungureanu, Maria-Christina, Branisteanu, Dumitru D., Preda, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296488/
https://www.ncbi.nlm.nih.gov/pubmed/37371500
http://dx.doi.org/10.3390/biom13060920
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author Bilha, Stefana Catalina
Hogas, Simona
Hogas, Mihai
Marcu, Stefan
Leustean, Letitia
Ungureanu, Maria-Christina
Branisteanu, Dumitru D.
Preda, Cristina
author_facet Bilha, Stefana Catalina
Hogas, Simona
Hogas, Mihai
Marcu, Stefan
Leustean, Letitia
Ungureanu, Maria-Christina
Branisteanu, Dumitru D.
Preda, Cristina
author_sort Bilha, Stefana Catalina
collection PubMed
description While chronic kidney disease-associated mineral and bone disorders (CKD-MBD) prevail in the endocrinological assessment of CKD patients, other endocrine abnormalities are usually overlooked. CKD is associated with significant thyroid, adrenal and gonadal dysfunction, while persistent and de novo endocrinological abnormalities are frequent among kidney transplant recipients (KTR). Low T3 levels prior to transplantation may help identify those at risk for delayed graft function and are often found in KTR. Thyroid surveillance after kidney transplantation should be considered due to structural anomalies that may occur. Despite the rapid recovery of gonadal hormonal secretion after renal transplantation, fertility is not completely restored. Testosterone may improve anemia and general symptoms in KTR with persistent hypogonadism. Female KTR may still experience abnormal uterine bleeding, for which estroprogestative administration may be beneficial. Glucocorticoid administration suppresses the hypothalamic-pituitary–adrenal axis in KTR, leading to metabolic syndrome. Patients should be informed about signs and symptoms of hypoadrenalism that may occur after glucocorticoid withdrawal, prompting adrenal function assessment. Clinicians should be more aware of the endocrine abnormalities experienced by their KTR patients, as these may significantly impact the quality of life. In clinical practice, awareness of the specific endocrine dysfunctions experienced by KTR patients ensures the correct management of these complications in a multidisciplinary team, while avoiding unnecessary treatment.
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spelling pubmed-102964882023-06-28 Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician Bilha, Stefana Catalina Hogas, Simona Hogas, Mihai Marcu, Stefan Leustean, Letitia Ungureanu, Maria-Christina Branisteanu, Dumitru D. Preda, Cristina Biomolecules Review While chronic kidney disease-associated mineral and bone disorders (CKD-MBD) prevail in the endocrinological assessment of CKD patients, other endocrine abnormalities are usually overlooked. CKD is associated with significant thyroid, adrenal and gonadal dysfunction, while persistent and de novo endocrinological abnormalities are frequent among kidney transplant recipients (KTR). Low T3 levels prior to transplantation may help identify those at risk for delayed graft function and are often found in KTR. Thyroid surveillance after kidney transplantation should be considered due to structural anomalies that may occur. Despite the rapid recovery of gonadal hormonal secretion after renal transplantation, fertility is not completely restored. Testosterone may improve anemia and general symptoms in KTR with persistent hypogonadism. Female KTR may still experience abnormal uterine bleeding, for which estroprogestative administration may be beneficial. Glucocorticoid administration suppresses the hypothalamic-pituitary–adrenal axis in KTR, leading to metabolic syndrome. Patients should be informed about signs and symptoms of hypoadrenalism that may occur after glucocorticoid withdrawal, prompting adrenal function assessment. Clinicians should be more aware of the endocrine abnormalities experienced by their KTR patients, as these may significantly impact the quality of life. In clinical practice, awareness of the specific endocrine dysfunctions experienced by KTR patients ensures the correct management of these complications in a multidisciplinary team, while avoiding unnecessary treatment. MDPI 2023-05-31 /pmc/articles/PMC10296488/ /pubmed/37371500 http://dx.doi.org/10.3390/biom13060920 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bilha, Stefana Catalina
Hogas, Simona
Hogas, Mihai
Marcu, Stefan
Leustean, Letitia
Ungureanu, Maria-Christina
Branisteanu, Dumitru D.
Preda, Cristina
Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title_full Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title_fullStr Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title_full_unstemmed Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title_short Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician
title_sort thyroid, gonadal and adrenal dysfunction in kidney transplant recipients: a review for the clinician
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296488/
https://www.ncbi.nlm.nih.gov/pubmed/37371500
http://dx.doi.org/10.3390/biom13060920
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