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Testosterone Replacement Therapy in Chronic Kidney Disease Patients

Ryszard Skiba1, Aleksandra Rymarz2, Anna Matyjek2

  • 1Department of General, Functional and Oncological Urology, Military Institute of Medicine, 04-141 Warsaw, Poland.

Nutrients
|August 26, 2022
PubMed

Insights

Testosterone replacement therapy (TRT) effectively improved hypogonadism symptoms and erectile dysfunction in men with chronic kidney disease (CKD) and those on hemodialysis. The treatment showed no significant safety risks regarding overhydration or prostate-specific antigen (PSA) levels.

Area of Science:

  • Nephrology
  • Endocrinology
  • Urology

Background:

  • Chronic kidney disease (CKD) and hemodialysis (HD) are associated with hypogonadism.
  • Hypogonadism affects a significant percentage of men with CKD (52%) and on HD (68.4%).

Purpose of the Study:

  • To evaluate the efficacy and safety of testosterone replacement therapy (TRT) in men with CKD and hypogonadism.
  • Assessed TRT in conservative (predialysis) and hemodialysis patient groups.

Main Methods:

  • 38 HD patients, 46 predialysis (PreD) CKD patients, and 35 controls were studied.
  • TRT administered via intramuscular testosterone enanthate injections every 3 weeks.
  • Safety monitored via prostate-specific antigen (PSA) and overhydration assessments.

Main Results:

  • Significant increase in total testosterone (TT) and free testosterone (fT) after 3 months of TRT.
  • Gradual decrease in hypogonadism symptoms (ADAM questionnaire) and erectile dysfunction (IIEF-5) over 12 months.
  • No significant changes in TT and fT after 3 months, and no significant safety concerns (PSA, overhydration).

Conclusions:

  • TRT effectively corrects clinical hypogonadism signs in CKD and HD patients.
  • The TRT regimen is safe, with no significant risk of overhydration or PSA elevation.
  • TRT offers a viable treatment option for hypogonadism in kidney disease patients.

Keywords:
chronic kidney diseaseerectile disfunctionfree testosteronehemodialysisserum testosterone leveltestosterone replacement therapytotal testosterone

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