Sexual Function and Testosterone Level in Men With Conservatively Treated Chronic Kidney Disease

Fugl-Meyer, Kerstin; Nilsson, Marie; Hylander, Britta; Lehtihet, Mikael

doi:10.1177/1557988317703207

Cited by 27 publications

(30 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Impaired sexual function is very common in end-stage renal disease (ESRD) patients, with a prevalence of 60–90% in both genders [ 1 , 2 , 3 ]. Although improvement of sexual dysfunction has been reported after kidney transplantation [ 4 , 5 , 6 ], some studies have shown that this condition can persist even after successful transplantation [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction after Kidney Transplantation

Perri

Izzo

Lofaro

et al. 2020

JCM

View full text Add to dashboard Cite

Patients with kidney transplantation often have a worse quality of life than the general population. One of the reasons for this, in male patients, is the high prevalence of erectile dysfunction. This is mainly due to the presence of comorbidities, surgery for kidney transplantation, adverse drug effects, psychological changes related to chronic disease, as well as hyperprolactinemia and hypogonadism. Whenever these endocrine dysfunctions occur after kidney transplantation, they must be corrected with appropriate treatment, i.e., testosterone replacement therapy. Administration of the phosphodiesterase-5 inhibitor (PDE5i) sildenafil at the recommended posology does not significantly alter the pharmacokinetics of the calcineurin inhibitors cyclosporin A or tacrolimus and does not impair kidney allograft function. Tacrolimus increases the peak concentration and prolongs the half-life of PDE5i in kidney transplant patients and, therefore, daily administration cannot be recommended due to the significant drop in blood pressure. Intracavernous injection or topical application of alprostadil can be a second-line option for the treatment of erectile dysfunction after kidney transplantation, which does not alter cyclosporine concentrations and does not deteriorate kidney function. Finally, penile prostheses can be successfully implanted following pelvic organ transplantation after eliminating the risk of infection associated with surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction after Kidney Transplantation

Perri

Izzo

Lofaro

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…It was proved that testosterone levels decrease along with a fall in glomerular filtration rate, and its deficit is most strongly expressed in patients with endstage renal disease. 10 In the general population, the prevalence of testosterone deficiency reaches a level of 6-12% in men aged over 30 years and 30% in men aged over 60 years. 11 In men treated with hemodialysis, hypogonadism is more frequent, and the percentage of patients suffering from this disorder ranges from 30% to 60%.…”

Section: Discussionmentioning

confidence: 99%

Lean Tissue Index and Body Cell Mass Can Be Predictors of Low Free Testosterone Levels in Men on Hemodialysis

Rymarz

Matyjek

Gomółka

et al. 2019

Journal of Renal Nutrition

View full text Add to dashboard Cite

Objective: Testosterone deficiency is a common disorder among men treated with hemodialysis. The aim of our study was to evaluate the relationship between free testosterone levels and body composition, biochemical markers of nutritional status, and inflammation in men on hemodialysis.Design: Prospective analysis of men treated with hemodialysis for more than 3 months in one hemodialysis center. Subjects: A total of 56 men-41 men undergoing hemodialysis treatment thrice-weekly over a period of at least 3 months (HD group) and 15 men without kidney disease, with estimated glomerular filtration rate .60 mL/min/1.73 m 2 (C group)-were included. Serum levels of free testosterone, creatinine, protein, albumin, prealbumin, high-sensitivity C-reactive protein, and interleukin 6 and body composition by bioimpedance spectroscopy, waist-to-hip ratio, and waist-to-height ratio were measured.Intervention: None, observational study. Main Outcome Measure: Free testosterone level.Results: The mean free testosterone level was significantly lower in the HD group than that in the C group and positively correlated with lean tissue index (LTI, r 5 0.51, P 5 .001) and body cell mass (BCM, r 5 0.57, P , .001). Significant, negative correlations were observed between free testosterone level and age (r 5 20.4, P 5 .004) as well as fat tissue index (r 5 20.36, P 5 .018). In a subgroup of men on hemodialysis who have low testosterone levels (,9.4 pg/mL), we observed a lower LTI and BCM and higher age, fat tissue index, and loginterleukin-6. In our receiver operating characteristic curve analysis, LTI and BCM were shown to be good predictors of a low testosterone level with cutoff points of 13.3 kg/m 2 and 22.3 kg, respectively, meaning that men on hemodialysis with LTI ,13.3 kg/ m 2 were 26 times more likely to have free testosterone levels below 9.4 pg/mL (odds ratio, 26.7; 95% confidence interval: 3.0-236.6).

show abstract

“…Both situations result in hypergonadotropic hypogonadism. Alternatively, as LH and prolactin are polypeptide hormones, their renal clearance may be decreased to a greater degree with impaired GFR than that of testosterone, which is a lipid-based hormone (14). This would lead to increased LH and prolactin levels while simultaneously lowering testosterone levels, due to increased clearance, thus again resulting in hypergonadotropic hypogonadism.…”

Section: Hormonal Abnormalitiesmentioning

confidence: 99%

Erectile dysfunction in renal failure and transplant patients

Fiuk¹,

Tadros²

2019

Transl. Androl. Urol

View full text Add to dashboard Cite

Erectile dysfunction (ED) is a prevalent and pertinent condition in the chronic kidney disease (CKD) population. It has a multifactorial etiology, including disruptions of the hypothalamic-pituitarygonadal axis, the endothelial paracrine signaling system, calcium and vitamin D homeostasis, along with several other factors. Efficacy of treatment of ED in the CKD population is comparable to non-CKD patients across multiple modalities, including PDE5 inhibitors, vacuum erectile devices, intracavernosal injections and penile prostheses. Renal transplant improves the contributing comorbid conditions that lead to ED in CKD patients; thus rates of ED are improved post-transplant. It is important to note that there is a small percentage of patients with persistent ED after renal transplantation.

show abstract

Sexual Function and Testosterone Level in Men With Conservatively Treated Chronic Kidney Disease

Cited by 27 publications

References 32 publications

Erectile Dysfunction after Kidney Transplantation

Erectile Dysfunction after Kidney Transplantation

Lean Tissue Index and Body Cell Mass Can Be Predictors of Low Free Testosterone Levels in Men on Hemodialysis

Erectile dysfunction in renal failure and transplant patients

Contact Info

Product

Resources

About