Androgens in the Anaemia of Chronic Renal Failure

Abstract

Plasma levels of testosterone-like substances (TLS) were depressed in seven patients with chronic renal failure. Intramuscular testosterone (as Sustanon 250® once a week) elevated plasma TLS levels to above normal throughout the week with an initial high peak. Sublingual testosterone produced a high but brief peak in TLS. Results were similar in renal failure patients and normal controls. A controlled trial of weekly Sustanon 250 in 24 regular dialysis patients produced a significant increase in haemoglobin from 6.8 to 8.2 g/dl. Side effects were mainly mild and acceptable but one patient developed priapism and another a large haematoma. The discriminate use of androgens is recommended for anaemic male patients on regular haemodialysis.

The pituitary-testicular axis of uraemic subjects on haemodialysis and continuous ambulatory peritoneal dialysis

“…It is the free fraction which is considered to be the active moiety. The tendency towards higher SHBG levels in our uraemic subjects may merely reflect their hypogonadal state as low levels of testosterone are known to be associated with high SHBG concentrations which are lowered by administration of androgen (Anderson 1972 Trials of androgen supplementation in uraemia have been attempted but the main aim has been to increase haemoglobin levels (Hendler et al 1974;Hartitzsch et al 1977). Replacement therapy with testosterone has not been widely employed because of the lack of an orally active preparation.…”

Effects of testosterone replacement and its pharmacogenetics on physical performance and metabolism

“…T treatment for anemia in patients with renal failure was a common medication before synthetic erythropoetin was available [50]. T probably acts directly on bone marrow at the level of polychromatophylic erythroblasts and enhances the synthesis of ribosomal RNA or its precursors and stimulates a nuclear ribonuclease.…”

Role of Testosterone in the Pathogenesis, Progression, Prognosis and Comorbidity of Men With Chronic Kidney Disease

“…von‐Hartitzsch et al. reported similar results on hemoglobin levels in 24 patients on HD. In addition, testosterone enanthate treatment (1 g/month) normalized hemoglobin values and replenished bone marrow iron stores .…”

“…Shaldon et al (98) reported an increase in hemoglobin levels after intramuscular administration of testosterone (250-500 mg weekly) in 25 patients on HD. von-Hartitzsch et al (99) reported similar results on hemoglobin levels in 24 patients on HD. In addition, testosterone enanthate treatment (1 g/month) normalized hemoglobin values and replenished bone marrow iron stores (100).…”