Journal Article

Prevalence and clinical implications of testosterone deficiency in men with end-stage renal disease

Juan Jesús Carrero, Abdul Rashid Qureshi, Ayumu Nakashima, Stefan Arver, Paolo Parini, Bengt Lindholm, Peter Bárány, Olof Heimbürger and Peter Stenvinkel

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 1, pages 184-190
Published in print January 2011 | ISSN: 0931-0509
Published online July 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq397
Prevalence and clinical implications of testosterone deficiency in men with end-stage renal disease

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Background. Abnormally low serum testosterone levels were recently associated with an increased mortality risk in male dialysis patients. However, the prevalence of testosterone deficiency in end-stage renal disease (ESRD) is not well defined. We hereby explore the prevalence and correlates of clinical testosterone deficiency in a large cohort of ESRD male patients.

Methods. Two hundred and sixty ESRD men [median age 59 (25th–75th percentile 48–67)  years] were included. Testosterone concentration and testosterone deficiency (<10 nmol/L) were studied in relation to clinically evident cardiovascular disease and markers of inflammation at baseline as well as deaths registered during the following 36 months.

Results. Testosterone deficiency was present in 44% of the patients, while 33% showed testosterone insufficiency (10–14 nmol/L), and only 23% had normal testosterone values (>14 nmol/L). Testosterone was strongly and inversely correlated to inflammatory markers (CRP, IL-6 and fibrinogen), even after correction for age and sex hormone-binding globulin. In a crude spline curve, low testosterone concentrations were associated with worse outcome. A clinical condition of testosterone deficiency was independently associated with cardiovascular co-morbidity [odds ratio (OR) 2.51; 95% confidence interval (CI) 1.32–4.76] and death (OR 2.00; 95% CI 1.01–3.97) in logistic regression analyses.

Conclusions. Testosterone deficiency is a common finding among male ESRD patients, and it is independently associated with inflammation, cardiovascular co-morbidity and outcome. Future studies are needed to determine the potential adverse effects of male hypogonadism in ESRD and the possibility of improving risk profile, quality of life, and ultimately outcome with testosterone supplementation in these patients.

Keywords: endocrine dysfunction; haemodialysis; risk factor; sex hormones

Journal Article.  4670 words.  Illustrated.

Subjects: Nephrology

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