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Testosterone Disorders and Male Hypogonadism in Kidney Disease
Giacomo Garibotto1, Pasquale Esposito1, Daniela Picciotto1
1Division of Nephrology, Dialysis and Transplantation, University of Genova, Genova, Italy Department of Internal Medicine, Istituto di Ricerca a Carattere Scientifico Ospedale Policlinico San Martino, Genova Italy.
Abstract:
Chronic kidney disease (CKD) causes substantial alterations in the male endocrine system, which affect puberty, libido, and sexual function. A major effect of CKD is a reduction in testosterone levels because of both primary and hypogonadotrophic hypogonadism. In addition to impairment of pubertal growth and sexual maturation in children with CKD, clinical evidence suggests that uremic hypogonadism strongly contributes to several CKD complications, including erectile dysfunction, muscle wasting and frailty, anemia, decreased bone mineralization, depression, and cognitive impairment. This review focuses on a reappraisal of the physiologic role of testosterone, with an emphasis on the hypogonadal condition linked to CKD and its complications.
Insights
Chronic kidney disease (CKD) significantly impacts male endocrine health, leading to reduced testosterone levels and hypogonadism. This condition contributes to various CKD complications, affecting sexual function and overall well-being.
Area of Science:
- Endocrinology
- Nephrology
- Male reproductive health
Background:
- Chronic kidney disease (CKD) profoundly affects the male endocrine system.
- CKD is associated with significant alterations in testosterone levels, leading to hypogonadism.
Purpose of the Study:
- To reappraise the physiological role of testosterone.
- To emphasize the hypogonadal condition linked to CKD and its complications.
Main Methods:
- Literature review
- Analysis of physiological roles of testosterone
- Examination of CKD-associated hypogonadism
Main Results:
- CKD causes primary and hypogonadotrophic hypogonadism, reducing testosterone levels.
- Uremic hypogonadism contributes to erectile dysfunction, muscle wasting, anemia, bone demineralization, depression, and cognitive impairment.
Conclusions:
- CKD-induced hypogonadism is a critical factor in disease progression and patient morbidity.
- Understanding testosterone's role in CKD is vital for managing complications and improving patient outcomes.
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