PRL and chronic kidney disease: Among the causes of hyperprolactinemia in CKD, the following stand out: (a) the established negative feedback loop in TIDA neurons is “highjacked,” promoting PRL production, (b) estrogens increase the inflammatory response, reducing dopamine production, therefore, enhancing PRL secretion, and (c) renal dysfunction directly alters the PRL metabolic clearance (Sievertsen et al., 1980).