<p>Advanced Chronic Kidney Disease is a Strong Predictor of Hypogonadism and is Associated with Decreased Lean Tissue Mass</p>

Abstract

Purpose In patients with chronic kidney disease (CKD), hypogonadism is more frequent than in the general population and its prevalence ranges between 40% and 60%. The aim of the study was to investigate the prevalence of hypogonadism and its association with kidney function, body composition, inflammatory markers and lipid disorders in patients with CKD. Materials and Methods The study population consisted of 112 men aged ≥40 years in different stages of CKD: 33 participants with eGFR ≥60 mL/min/1.73 m 2 , 27 men with eGFR 30–59 mL/min/1.73 m 2 , 17 predialysis patients with eGFR <30 mL/min/1.73 m 2 , and 35 men on hemodialysis therapy three times a week for more than 3 months (G5D stage). Total testosterone (TT) levels were measured and free testosterone (FT) levels were calculated. Body composition was assessed using bioimpedance spectroscopy (Body Composition Monitor, FMC). Statistical analysis was performed using Statistica version 13.1. Results CKD stage was a strong predictor of hypogonadism (providing an information value of 0.83). The weight of evidence technique allowed us to differentiate the high-risk group, which was a group of patients with advanced CKD, defined as eGFR <30 mL/min/1.73 m 2 . In this group, the likelihood of hypogonadism was 69.23%. Another significant predictor of hypogonadism was lean tissue index (LTI). TT and FT levels were significantly lower in the advanced CKD group in comparison to the control group, whereas prolactin, luteinizing hormone and C-reactive protein levels were significantly higher in the advanced CKD group. The LTI was significantly lower in advanced CKD and was positively correlated with TT and FT. Conclusion Decreased eGFR and decreased LTI are predictors of hypogonadism associated with CKD. The study results suggest that hypogonadism screening should be carried out when eGFR deceases below 30 mL/min/1.73 m 2 .

Fibroblast Growth Factor 23 (FGF23) is an Early Specific Marker in the Diagnosis and Staging of Chronic Kidney Disease (CKD) in Human

“…A similar phenomenon among the super-aged Japanese men was observed [41]. This phenomenon was associated with high level of aromatase [42].…”

Endocrine disorders in chronic kidney disease

“…Hypogonadism is more common in CKD patients than in the general population, with a prevalence of 40-60%. Total and free testosterone levels are significantly lower in patients with advanced CKD compared to controls (34) .…”

Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment

“…Endocrine dysfunction impacts protein breakdown and synthesis [44,57]. Specifically, hormones related to the development of sarcopenia in CKD are testosterone, myostatin and growth hormone/ insulin-like growth factor-1 (IGF-1) [44].…”

“…Specifically, hormones related to the development of sarcopenia in CKD are testosterone, myostatin and growth hormone/ insulin-like growth factor-1 (IGF-1) [44]. In men with CKD, the prevalence of hypogonadism was reported to be 46.4% [57]. When haemodialysis and NDD-CKD patients were compared with healthy controls, testosterone levels and muscle mass comparisons were lower in men [57].…”