P0838hyperprolactinemia in CKD Patients and Its Association With Strenght, Sexual Dysfunction Ans Quality of Life

Abstract

Background and Aims Hyperprolactinemia is a hormonal disorder associated with many diseases, including chronic kidney disease (CKD). Some studies have shown that serum prolactin (PRL) levels increase as CKD progresses, due to decreased renal clearance and increased production. This prolactin retention leads to inhibition of gonadotropic hormone production, and testosterone deficiency in male patients with CKD. Thus, this study aimed to evaluate PRL levels in male patients with different stages of CKD and its association with clinical and laboratory characteristics, strength, sexual dysfunction, and quality of life. Method This is a transversal study conducted in a tertiary hospital in southern Brazil. Patients with CKD stage IV and V were included and divided into three groups: 1) stage IV; 2) non-dialysis-dependent stage V and; 3) dialysis-dependent stage V (VD). Patients with prescribed hormone therapy were excluded. PRL, creatinine, testosterone, estradiol, albumin, SHBG, LH, and FSH levels were measured. Free testosterone was estimated by the Vermeulen equation. Patients were also evaluated for strength and musculoskeletal function through the “handgrip strength” test. For evaluation of the quality of life and sexual dysfunction, validated questionnaires were applied: AMS (Aging Male's Symptoms Scale), ADAM (Androgen Deficiency in the Aging Male) and SF-36 Health. Results In this study, 164 patients were included (IV=75; V=41; VD=48). The mean age was 64 [55-71] years and BMI 26,9 [23,3-30,04] kg/m2. The dialysis-dependent group had higher prevalence of hyperprolactinemia (22,6% vs. 49% vs. 66%, p<0,001), higher PRL (13,4 vs. 19,43 vs. 26,13, p<0,001) and estradiol (25,6 vs. 24,4 vs. 30,5, p=0,041). PRL levels were positive correlated with CKD stage (rs=0,482, p<0,001) and creatinine (rs=0,467, p<0,001) and negative correlated with testosterone (rs=-0,286, p<0,001) and free testosterone levels (rs=-0,307, p<0,001). There was no difference in PRL levels between hemodialysis and peritoneal dialysis (p=1,000). Analyzes related to the association of PRL levels with strength, quality of life, and sexual dysfunction are still being analyzed. Conclusion Hyperprolactinemia is associated with the severity of CKD, with a higher prevalence in dialysis patients. The relation of PRL levels with strength, quality of life, and sexual dysfunction are being evaluated.

Hyperprolactinemia in patients with chronic kidney disease

“…Підвищення ПЛ веде до пригнічення ГТГ, включаючи дефіцит тестостерону у пацієнтів з ХХН серед чоловіків, аменореї у жінок, був пов'язаний з прогресуванням атеросклерозу, хронічного запалення, ризиком ССЗ і смертністю, якістю життя, зниженням мінеральної щільності кісток [10]. ГПЛ може відображати реакцію нейроендокринного стресу на гострі коронарні синдроми, яка викликає гостру ендотеліальну дисфункцію, що підтверджується відмічається порушенням циркадного ритму секреції ПЛ та позитивним кореляційним зв'язком між рівнем ПЛ та тропоніну І [16].…”