Endocrine abnormalities in chronic renal failure

Much needs to be achieved for improving the survival and quality of life for chronic renal failure patients. Progress in attaining this goal may accrue from attention to underlying pathophysiologic processes early on and throughout a person's life history of chronic renal failure. The endocrine perturbations described in this review are alterations in the homeostasis of phosphorus, calcium, vitamin D, and parathyroid hormone; erythropoietin deficiency; and sexual dysfunction in uremia-good examples for the need to identify early and manage prospectively over time manifestations of chronic renal failure. The complexity of both the skeletal and extra-skeletal sequelae of dysregulated mineral metabolism and the complications of chronic anemia are discussed while stressing possible implications of these endocrine abnormalities for both morbidity and mortality. There is a great need for more randomized clinical trials to evaluate new and old treatment approaches, with the goal of developing better evidence-based practice guidelines.