Low serum testosterone levels and the incidence of chronic kidney disease among male adults: A prospective population‐based study

Abstract

Background: Despite existing evidence regarding the role of testosterone as a protective factor for the kidney function in male adults, there are conflicting and inconclusive results on the influence of testosterone deficiency on developing chronic kidney disease (CKD).Objective: This study aimed to investigate the incidence and hazard ratio of CKD among male adults with low testosterone levels compared to controls with normal testosterone levels. Materials and Methods: During a 15-year follow-up study, a total of 1277 eligible male adults aged 20-80 year consisting of 605 males with low testosterone levels (< 350 ng/dL) and 672 controls with normal levels participating in the Tehran Lipid andGlucose Study were recruited. Cox's proportional hazards models were applied to estimate hazard ratios of CKD between the groups after adjusting for confounders. Results:The total cumulative incidence rate of CKD at the median follow-up time of approximately 11.2 years was 21/1000 (95% CI: 18/1000, 25/1000) and 18/1000 (95% CI: 16/1000, 22/1000) in the low and normal testosterone groups, respectively (P = .2). The multivariate Cox model adjusted for age, body mass index, dyslipidemia, hypertension, diabetes, and smoking showed that HR of developing CKD in the male adults with low testosterone levels was significantly higher than those with normal levels (HR = 1.38; 95% CI: 1.05, 1.80). Discussion and conclusion:This study shows a higher hazard ratio of CKD progression in male adults with hypogonadism compared to those with normal levels in their later life. Therefore, timely diagnosis and treatment of kidney diseases in hypogonadal men can prevent the morbidity and mortality from CKD.

Is erectile dysfunction an early clinical symptom of chronic kidney disease?

“…It has been reported that TT has beneficial effects on kidney functions and that renal functions are also associated with erectile complaints. Especially in CKD patients, low TT levels have been associated with the progression of CKD [22]. In this study plan, we tried to examine whether ED is an early marker in patients who have ED complaints and have not had a problem or diagnosis associated with CKD before.…”

<p>Advanced Chronic Kidney Disease is a Strong Predictor of Hypogonadism and is Associated with Decreased Lean Tissue Mass</p>

“…29 On the other hand, the study by Amiri et al revealed that a hypogonadal state increased the hazard ratio of developing CKD in males by 1.26 in comparison to eugonadal men. 30 Aside from the influence of testosterone levels on muscle mass, this anabolic hormone can also affect fat tissue. Some researchers noted an inverse correlation between testosterone concentrations and fat mass in individuals with normal kidney function as well as in CKD patients.…”

Sex Differences in Renal Function: Participation of Gonadal Hormones and Prolactin

“…In CKD, sexual dysfunction is common in men [129]. Lower testosterone levels have a deleterious role since they are associated with an increased risk of developing CKD [130] and mortality in male patients receiving dialysis [131]. Shoskes et al reported a higher risk of graft loss in male kidney transplant recipients with lower testosterone levels [132].…”