Hypogonadism and Testosterone Replacement Therapy in End-stage Renal Disease (ESRD) and Transplant Patients

Overview

Journal Transl Androl Urol

Date 2017 Jan 13

PMID 28078220

Citations 7

Authors

Grace Snyder

Daniel A Shoskes

Affiliations

Soon will be listed here.

Abstract

Hypogonadism is a common problem in the end-stage renal disease (ESRD) and renal transplant population. It has widespread systemic effects and has been linked with mortality in dialysis patients and at the time of renal transplant. The etiology is likely multifactorial and most patients are afflicted by various comorbidities that can contribute to hypogonadism. Clinical manifestations are mostly nonspecific. We review the approach to the diagnosis of hypogonadism, focusing on both laboratory values and clinical signs and symptoms. We review treatment with testosterone replacement in this population and highlight various studies that tend to have small sample sizes. Though these studies provide insight into testosterone replacement, the need for larger studies is emphasized to better understand the effects and safety of therapy.

Citing Articles

Does the hemodialysis program affect the testosterone serum level in patients with end-stage renal disease?.

Mustafa M, Khaznah I, Hrezat D, Obaida L, Aghbar A Int Urol Nephrol. 2024; 57(3):785-791.

PMID: 39472402 DOI: 10.1007/s11255-024-04265-5.

Male sexual dysfunction in patients with chronic kidney disease: a cross-sectional study.

Fu R, He P, Hong W, Liang Y, Wang W, Yuan S Sci Rep. 2024; 14(1):9207.

PMID: 38649741 PMC: 11035701. DOI: 10.1038/s41598-024-59844-4.

The impact of long-term Testosterone Therapy (TTh) in renal function (RF) among hypogonadal men: An observational cohort study.

Alwani M, Al-Zoubi R, Al-Qudimat A, Yassin A, Aboumarzouk O, Al-Rumaihi K Ann Med Surg (Lond). 2021; 69:102748.

PMID: 34471531 PMC: 8387920. DOI: 10.1016/j.amsu.2021.102748.

A review and perspective on the assessment, management and prevention of fragility fractures in patients with osteoporosis and chronic kidney disease.

Hampson G, Elder G, Cohen-Solal M, Abrahamsen B Endocrine. 2021; 73(3):509-529.

PMID: 33974225 PMC: 8325650. DOI: 10.1007/s12020-021-02735-9.

Erectile dysfunction in renal failure and transplant patients.

Fiuk J, Tadros N Transl Androl Urol. 2019; 8(2):155-163.

PMID: 31080776 PMC: 6503231. DOI: 10.21037/tau.2018.09.04.

References

Shoskes D, Kerr H, Askar M, Goldfarb D, Schold J . Low testosterone at time of transplantation is independently associated with poor patient and graft survival in male renal transplant recipients. J Urol. 2014; 192(4):1168-71. DOI: 10.1016/j.juro.2014.03.102. View

Hackett G . Testosterone replacement therapy and cardiovascular events. BMJ. 2014; 349:g7230. DOI: 10.1136/bmj.g7230. View

Mirone V, Longo N, Fusco F, Verze P, Creta M, Parazzini F . Renal transplantation does not improve erectile function in hemodialysed patients. Eur Urol. 2008; 56(6):1047-53. DOI: 10.1016/j.eururo.2008.09.020. View

Chatterjee R, Wood S, McGarrigle H, Lees W, Ralph D, Neild G . A novel therapy with testosterone and sildenafil for erectile dysfunction in patients on renal dialysis or after renal transplantation. J Fam Plann Reprod Health Care. 2004; 30(2):88-90. DOI: 10.1783/147118904322995438. View

Moal V, Mathieu E, Reynier P, Malthiery Y, Gallois Y . Low serum testosterone assayed by liquid chromatography-tandem mass spectrometry. Comparison with five immunoassay techniques. Clin Chim Acta. 2007; 386(1-2):12-9. DOI: 10.1016/j.cca.2007.07.013. View

Holley J . The hypothalamic-pituitary axis in men and women with chronic kidney disease. Adv Chronic Kidney Dis. 2004; 11(4):337-41. View

Gungor O, Kircelli F, Carrero J, Asci G, Toz H, Tatar E . Endogenous testosterone and mortality in male hemodialysis patients: is it the result of aging?. Clin J Am Soc Nephrol. 2010; 5(11):2018-23. PMC: 3001774. DOI: 10.2215/CJN.03600410. View

Turk S, Guney I, Altintepe L, Tonbul Z, Yildiz A, Yeksan M . Quality of life in male hemodialysis patients. Role of erectile dysfunction. Nephron Clin Pract. 2004; 96(1):c21-7. DOI: 10.1159/000075568. View

Shamsa A, Motavalli S, Aghdam B . Erectile function in end-stage renal disease before and after renal transplantation. Transplant Proc. 2005; 37(7):3087-9. DOI: 10.1016/j.transproceed.2005.08.067. View

10.

Carrero J, Qureshi A, Parini P, Arver S, Lindholm B, Barany P . Low serum testosterone increases mortality risk among male dialysis patients. J Am Soc Nephrol. 2009; 20(3):613-20. PMC: 2653676. DOI: 10.1681/ASN.2008060664. View

11.

Gaughan W, Liss K, Dunn S, Mangold A, Buhsmer J, Michael B . A 6-month study of low-dose recombinant human erythropoietin alone and in combination with androgens for the treatment of anemia in chronic hemodialysis patients. Am J Kidney Dis. 1997; 30(4):495-500. DOI: 10.1016/s0272-6386(97)90307-3. View

12.

Bhasin S, Storer T, Berman N, Yarasheski K, Clevenger B, Phillips J . Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. J Clin Endocrinol Metab. 1997; 82(2):407-13. DOI: 10.1210/jcem.82.2.3733. View

13.

Van Coevorden A, Stolear J, DHaene M, Van Herweghem J, Mockel J . Effect of chronic oral testosterone undecanoate administration on the pituitary-testicular axes of hemodialyzed male patients. Clin Nephrol. 1986; 26(1):48-54. View

14.

Rosas S, Joffe M, Franklin E, Strom B, Kotzker W, Brensinger C . Association of decreased quality of life and erectile dysfunction in hemodialysis patients. Kidney Int. 2003; 64(1):232-8. DOI: 10.1046/j.1523-1755.2003.00042.x. View

15.

Bouloux P, Legros J, Elbers J, Geurts T, Kaspers M, Meehan A . Effects of oral testosterone undecanoate therapy on bone mineral density and body composition in 322 aging men with symptomatic testosterone deficiency: a 1-year, randomized, placebo-controlled, dose-ranging study. Aging Male. 2013; 16(2):38-47. DOI: 10.3109/13685538.2013.773420. View

16.

Carrero J, Barany P, Yilmaz M, Qureshi A, Sonmez A, Heimburger O . Testosterone deficiency is a cause of anaemia and reduced responsiveness to erythropoiesis-stimulating agents in men with chronic kidney disease. Nephrol Dial Transplant. 2011; 27(2):709-15. DOI: 10.1093/ndt/gfr288. View

17.

Barton C, Mirahmadi M, Vaziri N . Effects of long-term testosterone administration on pituitary-testicular axis in end-stage renal failure. Nephron. 1982; 31(1):61-4. DOI: 10.1159/000182618. View

18.

Teruel J, Marcen R, Navarro J, Villafruela J, Fernandez Lucas M, Liano F . Evolution of serum erythropoietin after androgen administration to hemodialysis patients: a prospective study. Nephron. 1995; 70(3):282-6. DOI: 10.1159/000188605. View

19.

Canguven O, Aykose G, Albayrak S, Goktas C, Horuz R, Yencilek F . Efficacy of testosterone gel in the treatment of erectile dysfunction in hypogonadal hemodialysis patients: a pilot study. Int J Impot Res. 2009; 22(2):140-5. DOI: 10.1038/ijir.2009.55. View

20.

Gan E, Pattman S, Pearce S, Quinton R . A UK epidemic of testosterone prescribing, 2001-2010. Clin Endocrinol (Oxf). 2013; 79(4):564-70. DOI: 10.1111/cen.12178. View