Endocrine Systems



The kidney is the organ that produces eryth­ropoietin and l,25(OH)2 vitamin D, the active me­tabolite of vitamin D. Renal disease is associated with low or absent levels of both these hormones. The kidney is also the organ of catabolism of sev­eral peptide hormones such as insulin, glucagon, parathyroid hormone, and gonadotropic hor­mones. Glucose intolerance is common in pa­tients with ESRD due, in part, to the abnormal circulating levels of hormones, to alterations in hormone-receptor interactions, and to changes in posthormonereceptor events in given cells. Ab­normalities in gonadal function are common in patients with advanced renal insufficiency. Preg­nancies and term deliveries are rare in females with ESRD. Menstrual periods also tend to be ir­regular.