Androgens for the anaemia of chronic kidney disease in adults

Yang, Qiming; Abudou, Minawaer; Xie, Xi; Wu, Taixiang

doi:10.1002/14651858.cd006881.pub2

Cited by 11 publications

(7 citation statements)

References 45 publications

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“…Since we excluded CKD patients who were on erythropoietin, we cannot comment on the relative contributions of erythropoietin and testosterone on hemoglobin concentrations in CKD. Neither is it known if T replacement therapy to normalize the T concentrations would decrease the need of erythropoietin therapy in anemic men with CKD (32,33).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease

Dhindsa

Reddy

Karam³

et al. 2015

European Journal of Endocrinology

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Background: One-third of men with type 2 diabetes have subnormal testosterone concentrations along with inappropriately normal LH and FSH concentrations. It is not known if the presence of renal insufficiency affects free testosterone concentrations in men with type 2 diabetes. Hypothesis: We hypothesized that type 2 diabetic men with chronic renal disease (CKD; estimated glomerular filtration rate (eGFR) !60 ml/min per 1.73 m 2 ) have lower free testosterone concentrations than men with normal renal function

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Section: Discussionmentioning

confidence: 99%

Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease

Dhindsa

Reddy

Karam³

et al. 2015

European Journal of Endocrinology

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“…A Cochrane review in 2014 found a paucity of studies on this topic and insufficient evidence to recommend androgen therapy for improving renal failureassociated anemia. 29 In view of the large magnitude of the problem and accompanying economic implications, it is surprising that the effect of testosterone on anemia of renal failure has not been investigated systematically. Unlike oral androgens, administration of testosterone by alternative routes (intramuscular and transdermal) does not lead to hepatotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Testosterone Decreases Erythropoietin Stimulating Agent Use in Men on Hemodialysis

Dhindsa

Nargunan

Reddy³

et al. 2020

Androgens: Clinical Research and Therapeutics

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Objective: Erythropoiesis stimulating agents (ESAs) are required in most of the patients with end-stage renal disease (ESRD) for treatment of anemia. Subnormal testosterone concentrations are very common in men with ESRD. Since testosterone is erythropoietic, testosterone replacement therapy (TRT) has the potential to increase hemoglobin and decrease ESA usage in hypogonadal men with ESRD. Methods: We reviewed charts of men on hemodialysis with subnormal testosterone concentrations at a dialysis center. The hemoglobin concentrations and ESA doses (adjusted for hemoglobin and body weight) of those who were treated with TRT (n = 10) were compared with those who did not receive TRT (n = 10). Results: The average duration of TRT was 18-2 weeks. Hemoglobin concentrations increased by 1.2-1.3 g/dL in the treated group but did not change in the untreated group (p = 0.02 for comparison between groups). ESA doses decreased by 20% in the TRT group but did not change in the untreated group (p = 0.03 for comparison between groups). Four out of the 10 men in the TRT group were no longer on ESAs by the end of the study, whereas all men in the untreated group continued to require ESAs throughout the study. Conclusion: TRT increases hemoglobin concentrations and reduces the requirement of ESAs in men with subnormal testosterone concentrations on hemodialysis.

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“…These changes could explain haemoglobin differences between men and women. 23,24 Our study is limited, as the data were collected from clinical records after implementation of the particular therapeutic strategy, and we had no control over the choice of immunosuppressants. Randomized, preferably case-control clinical trials are needed to corroborate our findings.…”

Section: Discussionmentioning

confidence: 99%

Androgens added to immunosuppressive regimen in patients with aplastic anaemia. A retrospective study

Ramos-Peñafiel

Ferrer-Argote

Trejo-Ayala

et al. 2015

Revista Médica Del Hospital General De México

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Background: Androgens have been used to treat bone marrow failure syndromes such as aplastic anaemia (AA) since the 1970s, and are currently used as adjuvants to other treatment regimens. Objective: To determine the efficacy and response time of androgens in the treatment of AA. Materials and methods: A retrospective, analytical-observational nested study in a cohort of patients with AA. The study was conducted from January 2006 to December 2013. Results: A total of 63 patients with a mean age of 47 (18---83) years were included in the study. Out of 27 patients in full remission, 17 received some type of immunosuppressant combined with androgens. The use of more than 2 immunosuppressants did not significantly improve response times (p = 0.311, 95% CI). Mean response time was 725 (331---1119) days; 4-year survival rate was 86%. Conclusions: Improved immunosuppressant response rates with adjuvant androgens were mainly observed in patients with severe AA. Anemia aplásica; Andrógenos; Resultado del tratamiento; Inmunosupresión; Estudio de cohorte Cohorte retrospectiva de la adición de andrógenos al régimen inmunosupresor en pacientes con anemia aplásica ResumenAntecedentes: Desde los sesenta se utilizan andrógenos para tratar síndromes de falla medular, como la anemia aplásica (AA), actualmente son complemento a otros tratamientos. Objetivo: Establecer la eficacia y tiempo de respuesta al tratamiento con andrógenos en AA. Material y Métodos: Estudio retrospectivo, observacional-analítico anidado en la cohorte de pacientes portadores de AA durante enero 2006 a diciembre 2013.Resultados: Se estudiaron 63 pacientes, con edad media de 47 (18---83) años. De 27 pacientes (42.9%) que integraron remisión completa, 17 recibían algún inmunosupresor en conjunto con andrógenos. Usar más de 2 inmunosupresores elevó no significativamente (p = 0.311, 95%IC) las respuestas. La media de respuesta fue de 725 (331---1,119) días. La supervivencia a 4 años fue del 86%. Conclusiones: Adicionar andrógenos mejoró la tasa de respuesta a los inmunosupresores principalmente en pacientes con AA muy severa.

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Androgens for the anaemia of chronic kidney disease in adults

Abstract: We found insufficient evidence to confirm that use of androgens for adults with CKD-related anaemia is beneficial.

Cited by 11 publications

References 45 publications

Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease

Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease

Testosterone Decreases Erythropoietin Stimulating Agent Use in Men on Hemodialysis

Androgens added to immunosuppressive regimen in patients with aplastic anaemia. A retrospective study

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