The Endocrine Giants of Chronic Kidney Disease.

Sharma S, Sharma N, Kalra S
JPMA. The Journal of the Pakistan Medical Association · 2026 · doi:10.47391/jpma.26-13 · PMID:41830373
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This paper proposes a framework identifying six endocrine giants in chronic kidney disease, including anaemia and hypogonadism, to manage multisystem complications.

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This review conceptualizes chronic kidney disease as an endo-metabolic disorder driven by six significant hormonal and electrolyte imbalances: anaemia, secondary hyperparathyroidism, hypovitaminosis D, hypogonadism, hyperkalaemia, and hyponatraemia. The authors argue that these factors collectively exert detrimental effects on cardiovascular, skeletal, metabolic, and neurological health, thereby increasing overall morbidity and mortality. They propose that early recognition and prompt management of these conditions can attenuate downstream cardiometabolic sequelae through a holistic nephrology care approach. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Chronic Kidney Disease (CKD) is increasingly being recognized as an endo-metabolic disorder in which a cascade of hormonal and electrolyte imbalances impacts the morbidity and mortality. We propose six "endocrine giants" of CKD- anaemia, secondary hyperparathyroidism, hypovitaminosis D, hypogonadism, hyperkalaemia, and hyponatraemia- each exerting a detrimental effect on cardiovascular, skeletal, metabolic, and neurological health. Their early recognition and prompt management can attenuate downstream cardiometabolic sequelae. This "endocrine giants" framework provides an integrative approach to managing CKD as a multisystem endocrine disorder and offers practical direction for holistic nephrology care.
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The Endocrine Giants of Chronic Kidney Disease DOI: https://doi.org/10.47391/JPMA.26-13Abstract Chronic Kidney Disease (CKD) is increasingly being recognized as an endo-metabolic disorder in which a cascade of hormonal and electrolyte imbalances impacts the morbidity and mortality. We propose six “endocrine giants” of CKD- anaemia, secondary hyperparathyroidism, hypovitaminosis D, hypogonadism, hyperkalaemia, and hyponatraemia- each exerting a detrimental effect on cardiovascular, skeletal, metabolic, and neurological health. Their early recognition and prompt management can attenuate downstream cardiometabolic sequelae. This “endocrine giants” framework provides an integrative approach to managing CKD as a multisystem endocrine disorder and offers practical direction for holistic nephrology care. Keywords: Chronic kidney disease, Anaemia, Secondary hyperparathyroidism, Hypovitaminosis D, Hyperkalaemia, Hyponatraemia, Hypogonadism Downloads Published How to Cite Issue Section License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.

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last seen: 2026-08-30T09:23:35.175841+00:00