Testosterone Replacement Therapy in Chronic Kidney Disease Patients

Skiba, Ryszard; Rymarz, Aleksandra; Matyjek, Anna; Dymus, Jolanta; Woźniak-Kosek, Agnieszka; Syryło, Tomasz; Zieliński, Henryk; Niemczyk, Stanisław

doi:10.3390/nu14163444

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…In recent years, some single-center research institutions have attempted to use TRT to observe whether it can improve the prognosis of CKD and reduce the incidence of complications. For example, according to Skiba et al [ 3 ], TRT administration in CKD patients undergoing dialysis or predialysis significantly improved clinical symptoms of hypogonadism and erectile dysfunction. Yeo et al [ 27 ] found that grip strength significantly improved and quality of life improved markedly after TRT in a retrospective study on CKD patients.…”

Section: Discussionmentioning

confidence: 99%

“…In males, this manifests as erectile dysfunction, while in females it leads to menstrual irregularities and decreased fertility due to steroid hormone secretion disruption, especially testosterone deficiency [ 2 ]. Testosterone replacement therapy (TRT) has been shown to alleviate hypogonadism in CKD patients [ 3 ], and males with low testosterone levels are at a significantly greater risk for developing CKD than those with normal testosterone levels [ 4 ]. Testosterone plays an important role in improving alertness and physical performance, enhancing libido, increasing muscle strength, and boosting the immune system.…”

Section: Introductionmentioning

confidence: 99%

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Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database

Pan,

Zheng,

Mao

et al. 2024

World J Mens Health

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Purpose The causal relationship between the incidence and prognosis of chronic kidney disease (CKD) and serum testosterone levels in patients is not yet fully understood. This study aims to use the National Health and Nutrition Examination Survey (NHANES), a large-scale nationally representative sample, to investigate the relationship between CKD and testosterone. Materials and Methods This study included six NHANES cycles for linear regression analysis, verified by multiple imputation methods. Stratified analysis and subgroup analysis were used to demonstrate the stability of CKD’s effect on testosterone. Furthermore, we used Kaplan-Meier plots and log-rank tests to evaluate differences in survival rates between CKD male patients with low and normal levels of testosterone. Results From a total of 71,163 subjects, the cohort selected 28,663 eligible participants. Results showed that CKD patients had testosterone levels 28.423 ng/mL (24.762, 32.083) lower than non-CKD patients. The results of multiple imputations (β=27.700, 95% confidence interval: 23.427, 31.974) were consistent with those of linear regression analysis, and the numerical match was good. Stratified regression analysis, and subgroup analysis results showed that CKD had a significant impact on testosterone at different dimensions. Kaplan-Meier plots showed significantly reduced survival rates in low testosterone CKD male patients (p<0.0001). Conclusions The results of this big data analysis suggest that there may be a two-way risk between low levels of testosterone and CKD. The testosterone levels of CKD patients were significantly lower than those of the non-CKD population, and CKD patients with low testosterone levels had poorer prognoses. These results suggest that correcting testosterone levels in a timely manner can have preventive and therapeutic effects on the progression of CKD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database

Pan,

Zheng,

Mao

et al. 2024

World J Mens Health

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“…randomly divided anemic dialysis patients into two groups: the first group received three times weekly erythropoietin whereas the second group was given equal doses of erythropoietin in addition to nandrolone decanoate weekly. Hemoglobin levels were improved in both groups but were significantly better in the second group [ 39 , 40 ]. The impact of testosterone supplementation in HD patients was also investigated by Teruel et al .…”

Section: Discussionmentioning

confidence: 99%

Hypogonadism in hemodialysis patients: a first snapshot of prevalence and predictive factors in Tunisian patients

Bannour,

Ati,

El Ati

et al. 2023

Pan Afr Med J

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Introduction patients with chronic kidney disease commonly exhibit testosterone deficiency. We aimed through the current study to assess the prevalence and the risk factors of hypogonadism in male patients on hemodialysis and to establish their relationship with erectile dysfunction. Methods we conducted a cross-sectional study based on data collected from hemodialysis male patients. Sociodemographic and clinical data as well as hormone levels were collected from January 2017 to December 2017. Sex hormones were measured in all subjects. The International Index of Erectile Function was used to evaluate erectile dysfunction. Data were expressed as mean ± standard deviation, and frequencies (number), and proportions (%). Results one hundred and ten: 55 male hemodialysis patients were recruited. The level of follicule-stimulating hormone, luteinizing hormone and prolactin were high and the level of testosterone was low in the hemodialysis group. Hypogonadism was significantly linked to advanced age, anemia, and absence of treatment by erythropoietin. The incidence of erectile dysfunction was high and the erectile function score was low. Testosterone significantly dropped in patients with erectile dysfunction. Conclusion hypogonadism was so prevalent in the hemodialysis men and it was associated with erectile dysfunction. Future studies are needed to determine the effect of testosterone therapy on erectile dysfunction.

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“…For example, hypogonadal males with diabetes have a higher plaque score, coronary artery disease, and cardiovascular mortality risk [ 13 , 14 ], which might be due to hyperlipidemia induced by lower androgen levels [ 15 ]. Additionally, hypogonadism is also associated with chronic kidney disease which mainly occurs as a consequence of diabetes [ 16 , 17 ]. Therefore, it is important to study reproductive disorders caused by diabetes because it might be associated with damage caused to other systems as well.…”

Section: Introductionmentioning

confidence: 99%

Effect of High-Fructose Diet-Induced Metabolic Syndrome on the Pituitary-Gonadal Axis in Male Rats

et al. 2022

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Plasma testosterone levels have been found to decrease in older insulin-resistant male patients. Both lower total testosterone levels and a higher incidence of metabolic syndrome have also been reported. The aim of this study was to investigate the effects of high-fructose diet-induced diabetes on both the testosterone release by Leydig cells and the activity of the hypothalamus–pituitary–gonadal (HPG) axis in male rats. Male rats were fed with either standard chow (control group) or a high-fructose diet (fructose-fed group) for 21 weeks. Hyperglycemia, hyperinsulinemia, and hypertension were observed in the fructose-fed group. Moreover, plasma testosterone and LH levels decreased in the fructose-fed group compared to the control group. Sperm motility was also reduced by 15% in the fructose-fed rats. In contrast, the basal release of testosterone from rat Leydig cells was not altered by fructose feeding. Moreover, in vitro studies showed that the testosterone release, in response to different stimulants, including forskolin (an adenylyl cyclase activator, 10−5 M), 8-Br-cAMP (a permeable analog of cAMP, 10−5 M), A23187 (a calcium ionophore, 10−5 M), or 25-hydroxy-cholesterol (water-soluble cholesterol, 10−5 M), did not significantly differ between the fructose-fed and control groups. Interestingly, the release of testosterone in response to human chorionic gonadotropin (hCG, 0.05 IU/mL) was enhanced by eightfold in the control group, but elevenfold in the fructose-fed group. LH receptor expression in rat Leydig cells was also increased. Moreover, LH secretion from the anterior pituitary was altered in the fructose diet-fed group. These results suggest that fructose diet-fed rats have lower plasma testosterone levels, which can lead to a higher sensitivity of hCG in Leydig cells.

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Testosterone Replacement Therapy in Chronic Kidney Disease Patients

Cited by 6 publications

References 30 publications

Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database

Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database

Hypogonadism in hemodialysis patients: a first snapshot of prevalence and predictive factors in Tunisian patients

Effect of High-Fructose Diet-Induced Metabolic Syndrome on the Pituitary-Gonadal Axis in Male Rats

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