There is growing appreciation of the complex interaction between various endocrine disorders and kidney disease (Fig. 1). 1 Rhee CM Brent GA Kalantar-Zadeh K Front matter.

in: Rhee CM Brent GA Kalantar-Zadeh K, Diagnosis and treatment of endocrine disorders in kidney disease.1st ed. Springer Science, New York, NY2019

Among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), numerous endocrine derangements may ensue and progress, particularly in the uremic milieu (ie, insulin resistance, 2 de Boer IH Zelnick L Afkarian M et al. Impaired glucose and insulin homeostasis in moderate-severe CKD.

J Am Soc Nephrol. 2016; 27: 2861-2871

hypogonadotropic hypogonadism, 3 Bello AK Stenvinkel P Lin M et al. Serum testosterone levels and clinical outcomes in male hemodialysis patients.

Am J Kidney Dis. 2014; 63: 268-275

,4 Yu J Ravel VA You AS et al. Association between testosterone and mortality risk among U.S. males receiving dialysis.

Am J Nephrol. 2017; 46: 195-203

and secondary hyperparathyroidism 5 Lau WL Obi Y Kalantar-Zadeh K Parathyroidectomy in the management of secondary hyperparathyroidism.

Clin J Am Soc Nephrol. 2018; 13: 952-961

). In turn, the kidneys serve as a major target of the endocrine system, such that alterations in renal structure and function may arise from untreated hormonal derangements (ie, diabetes, 6 Reidy K Kang HM Hostetter T Susztak K Molecular mechanisms of diabetic kidney disease.

J Clin Invest. 2014; 124: 2333-2340

hypothyroidism, 7 The interaction between thyroid and kidney disease: an overview of the evidence.

Curr Opin Endocrinol Diabetes Obes. 2016; 23: 407-415

and testosterone deficiency 8 Park KM Kim JI Ahn Y Bonventre AJ Bonventre JV Testosterone is responsible for enhanced susceptibility of males to ischemic renal injury.

J Biol Chem. 2004; 279: 52282-52292

). Furthermore, the kidney in and of itself is a critical endocrine organ, responsible for producing hormones that are essential to both renal and extrarenal health (ie, erythropoietin, calcitriol, and renin). 9 The kidney as an endocrine organ.

in: Singh A Williams G, Textbook of nephro-endocrinology: hormones in kidney disease.2nd ed. Elsevier, New York, NY2017

Figure 1Conceptual model of the inter-relationships between the endocrine system and kidney health. Abbreviation: CKD, chronic kidney disease.