Evaluation of the Hypothalamic-Pituitary Axis in Uremic Males Using Dynamic Tests. The Possible Role of Testicular Inhibin: A Preliminary Report

Abstract

Two dynamic tests (Gn-RH i.v. and clomiphene citrate-CC p.o.) were used to evaluate the hypothalamic-pituitary axis in hemodialysis patients and renal transplant recipients (recipients). In the Gn-RH test the gonadotropin secretion was maximally decelerated in hemodialysis patients while it was normal in recipients. During the CC test a decrease of gonadotropin secretion, chronically and quantitatively identical for both group, was found; while on the following test days an increase was noted, which was more accelerated in male recipients. In cases with uremia a strong negative feedback dominates at the pituitary level probably owing to testicular inhibin. The estrogenic feedback in uremia was intact, while the antiestrogenic feedback at the level of hypothalamus is partly impaired, owing to altered opioid metabolism.

Influence of Sex Hormones on Prostate Volume in Men on Hemodialysis

“…The present study showed that males with chronic renal failure on hemodialysis have hyperestrogenemia. It is not clear why our results differ from those of Mastrogiacomo et al (1988), Kokot et al (1995), and Chryssicopoulos et al (1996). However, these studies can be faulted for the use of inappropriate controls and lack of morning blood samples.…”

“…The endocrinologic status of chronic renal failure in males with elevated gonadotropin levels and decreased testosterone levels is well documented (Handelsman, 1985;Mastrogiacomo et al, 1988;Handelsman and Dong, 1993). In contrast, the findings relating to estrogen levels have been variable: increased (Lim and Fang, 1976), decreased (Mastrogiacomo et al, 1988;Kokot et al, 1995) or unchanged (Chryssicopoulos et al, 1996). The present study showed that males with chronic renal failure on hemodialysis have hyperestrogenemia.…”

“…In these patients, elevated levels of gonadotropins and decreased testosterone levels are common endocrine characteristics (Mastrogiacomo et al, 1988). For estrogens, a complex picture has been reported, including increased, normal, and decreased levels (Kokot et al, 1995;Chryssicopoulos et al, 1996). Therefore, in the present study, we examined serum concentrations of estradiol and total and free testosterone in men on hemodialysis.…”

Erectile function and gonadal hormones levels in men with end-stage renal disease: It's relevance to duration of haemodialysis

“…FSH concentration appears to increase in uraemic patients because of the damage to sertoli cells, resulting in the suppression of inhibin production (Chryssicopoulos et al, 1996). FSH concentration appears to increase in uraemic patients because of the damage to sertoli cells, resulting in the suppression of inhibin production (Chryssicopoulos et al, 1996).…”

“…Inhibin, produced by Sertoli cells, negatively regulates FSH release from the pituitary gland. FSH concentration appears to increase in uraemic patients because of the damage to sertoli cells, resulting in the suppression of inhibin production (Chryssicopoulos et al, 1996).…”