Concepción-Zavaleta MJ, Fuentes-Mendoza JM, López-Ramírez EP, Martínez-García JA, Concepción-Urteaga LA, Paz-Ibarra J. Endocrine disorders linked to chronic kidney disease: Mechanisms and clinical implications. World J Nephrol 2026; 15(1): 113875 [DOI: 10.5527/wjn.v15.i1.113875]
Corresponding Author of This Article
Marcio J Concepción-Zavaleta, MD, Grupo de Investigación en Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria, Universidad Científica del Sur, 19 Panamericana Sur Km, Villa El Salvador, Lima 15067, Peru. mconcepcion@cientifica.edu.pe
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Mar 25, 2026; 15(1): 113875 Published online Mar 25, 2026. doi: 10.5527/wjn.v15.i1.113875
Endocrine disorders linked to chronic kidney disease: Mechanisms and clinical implications
Marcio J Concepción-Zavaleta, Jenyfer M Fuentes-Mendoza, Elida P López-Ramírez, Jesús A Martínez-García, Luis A Concepción-Urteaga, José Paz-Ibarra
Marcio J Concepción-Zavaleta, Jenyfer M Fuentes-Mendoza, Grupo de Investigación en Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria, Universidad Científica del Sur, Lima 15067, Peru
Elida P López-Ramírez, Jesús A Martínez-García, School of Medicine, Universidad Autónoma de San Luis Potosí, San Luis Potosi 2405, Mexico
Luis A Concepción-Urteaga, School of Medicine, Universidad Nacional de Trujillo, Trujillo 13011, La Libertad, Peru
José Paz-Ibarra, Department of Endocrinology, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
José Paz-Ibarra, School of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
Co-first authors: Marcio J Concepción-Zavaleta and Jenyfer M Fuentes-Mendoza.
Author contributions: Concepción-Zavaleta MJ supervised the entire process; Concepción-Zavaleta MJ and Fuentes-Mendoza JM conceived and designed the study, they contributed equally to this article, they are the co-first authors of this manuscript; López-Ramírez EP, Martínez-García JA, Concepción-Urteaga LA, and Paz-Ibarra J conducted the literature search and data collection; Fuentes-Mendoza JM, López-Ramírez EP, and Martínez-García JA drafted the initial manuscript; Concepción-Zavaleta MJ, Concepción-Urteaga LA, and Paz-Ibarra J critically revised the manuscript for important intellectual content; and all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Marcio J Concepción-Zavaleta, MD, Grupo de Investigación en Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria, Universidad Científica del Sur, 19 Panamericana Sur Km, Villa El Salvador, Lima 15067, Peru. mconcepcion@cientifica.edu.pe
Received: September 5, 2025 Revised: September 26, 2025 Accepted: December 15, 2025 Published online: March 25, 2026 Processing time: 190 Days and 5.9 Hours
Abstract
Chronic kidney disease (CKD) is a progressive condition that disrupts multiple endocrine axes, contributing to a broad range of hormonal imbalances, including mineral and bone disorder, gonadal dysfunction, thyroid abnormalities, insulin resistance, and elevated prolactin levels. These disturbances not only exacerbate comorbidities such as cardiovascular disease, anemia, diabetes, and sarcopenia, but may also accelerate the decline of renal function. This article aims to provide a comprehensive overview of the pathophysiology, clinical impact, and management strategies for endocrine disorders in CKD. A narrative literature search was conducted using PubMed, EMBASE, the Cochrane Library, and Scielo through July 2025, focusing on 141 studies addressing endocrine complications in CKD. The prevalence of hormonal dysfunction increases with CKD progression, affecting over 70% of patients in advanced stages. Disruptions in calcium and phosphate homeostasis lead to secondary hyperparathyroidism, vascular calcification, and bone fragility. Thyroid hormone alterations and testosterone deficiency contribute to reduced muscle mass, fatigue, and cardiovascular risk. Impaired glucose metabolism complicates glycemic control, particularly in dialysis and post-transplant populations. Diagnostic interpretation is often challenged by altered hormone clearance and protein binding. Therapeutic approaches require individualized strategies, including dietary and pharmacological correction of mineral imbalances, cautious hormone replacement, and use of agents such as dopamine agonists or sodium-glucose cotransporter-2 inhibitors. A multidisciplinary approach integrating nephrology and endocrinology is essential to improve outcomes and quality of life in this population.
Core Tip: Chronic kidney disease disrupts multiple endocrine pathways, leading to mineral and bone disorders, thyroid dysfunction, hypogonadism, insulin resistance, and prolactin elevation. These hormonal disturbances exacerbate cardiovascular disease, anemia, sarcopenia, and impaired quality of life. This narrative review synthesizes current evidence on mechanisms, diagnostic challenges, and therapeutic strategies for endocrine complications in chronic kidney disease. By highlighting the bidirectional relationship between kidney and endocrine dysfunction, it underscores the need for integrated nephrology-endocrinology management to optimize patient outcomes.
