Neuroendocrine adaptations in renal disease

Reinhard Feneberg, Franz Schaefer, Johannes D Veldhuis

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Chronic renal failure (CRF) disrupts the time-dependent secretion of multiple hormones. The present review focuses on altered pulsatile release of peptide hormones. CRF is marked by impaired tissue actions, disorderly release patterns, and relative [growth hormone (GH)] or absolute [luteinizing hormone (LH)] deficiency of secretion. At the hypothalamo-pituitary level, experimental evidence suggests that CRF reduces the synthesis and/or release of the cognate hypothalamic releasing factors, GHRH and LHRH, and enforces excessive inhibition by somatostatin. Parathyroid hormone (PTH) and insulin are secreted in both basal and pulsatile modes, wherein the latter is putatively coordinated by autonomic innervation. Amplitude and frequency-dependent adaptations of PTH and insulin outflow fail in CRF, as assessed under steady-state conditions and during metabolic drive (i.e., calcium for PTH and glucose for insulin). A common feature in CRF is a diminished mass of hormone released per burst, due in principle to attenuation of feed-forward signals and/or accentuation of (unknown) feedback signals. Damping of neuronal control and/or prolonged network response times may contribute to aberrant pulse frequency, disproportionate basal (nonpulsatile) hormone release, and consistent erosion of secretory process regularity in the uremic state. The homeostatic consequences of distorted secretory dynamics, tissue resistance, impaired hormone clearance, and altered mean agonist concentrations are evident in certain therapeutic interventions, such as GH supplementation in CRF.

Original languageEnglish (US)
Pages (from-to)492-497
Number of pages6
JournalPediatric Nephrology
Volume18
Issue number6
StatePublished - Jun 1 2003

Fingerprint

Chronic Kidney Failure
Kidney
Parathyroid Hormone
Hormones
Insulin
Growth Hormone
Pituitary Hormone-Releasing Hormones
Peptide Hormones
Secretory Pathway
Luteinizing Hormone
Somatostatin
Gonadotropin-Releasing Hormone
Reaction Time
Calcium
Glucose

Keywords

  • Chronic renal failure
  • Growth hormone
  • Insulin
  • Luteinizing hormone
  • Neuroendocrine secretion
  • Parathyroid hormone
  • Pulsatile hormone secretion

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Feneberg, R., Schaefer, F., & Veldhuis, J. D. (2003). Neuroendocrine adaptations in renal disease. Pediatric Nephrology, 18(6), 492-497.

Neuroendocrine adaptations in renal disease. / Feneberg, Reinhard; Schaefer, Franz; Veldhuis, Johannes D.

In: Pediatric Nephrology, Vol. 18, No. 6, 01.06.2003, p. 492-497.

Research output: Contribution to journalArticle

Feneberg, R, Schaefer, F & Veldhuis, JD 2003, 'Neuroendocrine adaptations in renal disease', Pediatric Nephrology, vol. 18, no. 6, pp. 492-497.
Feneberg R, Schaefer F, Veldhuis JD. Neuroendocrine adaptations in renal disease. Pediatric Nephrology. 2003 Jun 1;18(6):492-497.
Feneberg, Reinhard ; Schaefer, Franz ; Veldhuis, Johannes D. / Neuroendocrine adaptations in renal disease. In: Pediatric Nephrology. 2003 ; Vol. 18, No. 6. pp. 492-497.
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