Journal Article

The vulnerable man: impact of testosterone deficiency on the uraemic phenotype

Juan Jesús Carrero and Peter Stenvinkel

in Nephrology Dialysis Transplantation

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

Volume 27, issue 11, pages 4030-4041
Published in print November 2012 | ISSN: 0931-0509
Published online September 2012 | e-ISSN: 1460-2385 | DOI:
The vulnerable man: impact of testosterone deficiency on the uraemic phenotype

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Testosterone deficiency or hypogonadism is a common finding in men undergoing dialysis, to a great extent a consequence of the failing kidney per se. Testosterone restoration in hypogonadism is common practice among endocrinologists. However, there is currently little awareness of this condition among both uremic patients and nephrologists, and in many cases, testosterone deficiency remains unscreened and untreated. This review article summarizes our current understanding of the role of testosterone deficiency at the crossroad of cardiometabolic complications of patients with chronic kidney disease. Pathways discussed include, among others, the plausible role of testosterone deficiency in the development of anaemia and ESA hyporesponsiveness, muscle catabolism, endothelial dysfunction, cognitive dysfunction, decreased libido, cardiovascular disease and mortality. As there are limited sources to guide decision-making, we also review existing testosterone replacement therapy studies in the context of CKD as well as considerations for side and adverse effects. This review makes a case for consideration of screening and better management of hypogonadism in men undergoing dialysis.

Keywords: anaemia; androgen; haemodialysis; hormone; men

Journal Article.  8075 words.  Illustrated.

Subjects: Nephrology

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