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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney

Mahmut Ilker Yilmaz1, Alper Sonmez, Abdul Rashid Qureshi

  • 1Department Nephrology, School of Medicine, Ankara, Turkey. Juan.jesus.carrero@ki.se

Clinical Journal of the American Society of Nephrology : CJASN
|June 25, 2011
PubMed

Insights

Low testosterone levels in men with chronic kidney disease (CKD) are linked to poor vascular function and increased cardiovascular risk. Maintaining testosterone may reduce these risks in CKD patients.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiology

Background:

  • Kidney function decline commonly impairs testosterone production, leading to hypogonadism in men with chronic kidney disease (CKD).
  • Testosterone's role in atherosclerosis is suggested in non-renal populations, and low testosterone is linked to mortality in male dialysis patients.
  • This study investigates the relationship between testosterone levels, vascular issues, and cardiovascular events in men with non-dialysis CKD.

Purpose of the Study:

  • To examine the association between testosterone levels and endothelial dysfunction in men with nondialysis CKD.
  • To determine if testosterone levels predict future cardiovascular events in this patient group.

Main Methods:

  • A cross-sectional analysis of 239 male CKD patients (stages 1-5) was conducted.
  • Flow-mediated dilation (FMD) was assessed, along with routine measurements and serum total and free testosterone.
  • Patients were followed for cardiovascular outcomes over a median of 31 months.

Main Results:

  • Testosterone levels (total and free) decreased as kidney function worsened.
  • Both total and free testosterone independently explained variance in FMD.
  • A 22% reduced risk of cardiovascular events was observed for each 1 nmol/L increase in total testosterone, persisting after adjustments.

Conclusions:

  • Reduced endogenous testosterone in progressive CKD is associated with endothelial dysfunction.
  • Lower testosterone levels exacerbate the risk of future cardiovascular events in men with nondialysis CKD.
Abstract

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