Possible role of elevated serum testosterone in pathogenesis of renal stone formation

Abstract

Background:Urolithiasis or renal stone formation occurs with three times higher frequency in males and decreases with age in parallel with the serum testosterone levels, suggesting a role played by male sex hormones. Androgens appear a promotion action and estrogens an inhibitory action on kidney stone formation in several animal models suggesting a study to be carried out to deduce the role played by serum testosterone in the formation of renal stones.Aim:The aim of this study is to define the involvement of serum total testosterone, free testosterone, and dihydrotestosterone in the pathogenesis of urolithiasis in males by comparing the results with healthy males with no present or past history of urolithiasis as controls.Materials and Methods:A case–control study was undertaken with 108 participants: 78 males diagnosed with urolithiasis and 30 age-matched healthy males.Results:The difference between mean age and body mass index of patients and controls were found to be nonsignificant. The total serum testosterone levels, serum dihydrotestosterone levels, were found to be higher in patients when compared to controls, and the difference was found to be significant. The levels of free testosterone and serum estradiol were also found to be higher in urolithiatic patients.Conclusion:The study demonstrates that elevated levels of serum testosterone and serum dihydrotestosterone might be involved in increased incidences of stone formation. The higher levels of estradiol do not seem to be a protective factor in males with urolithiasis with higher serum testosterone levels.

Urinary Calculi: A Microbiological and Biochemical Analysis at a Tertiary Care Hospital in Eastern Nepal

“…In the context of our study, male preponderance was observed. It can be attributed to effect of sex hormones on some lithogenic risk factors and concentration of lithogenic factors in the urine which is greater in men than that in women [ 14 – 17 ].…”

Decreased Risk of Renal Calculi in Patients Receiving Androgen Deprivation Therapy for Prostate Cancer

“…Renal calculi are more prevalent in males and postmenopausal females, indicating the possible role of androgen in renal calculi formation. A significantly higher level of testosterone was reported in those with renal calculi [16,18,19,22]. In Mohammad's study, the testosterone level was 3.3 ng/mL in patients with renal calculi and 2.41 ng/mL in the control group [18].…”

“…ADT may alter the risk of renal calculi. A significantly higher level of androgen was observed in patients with renal calculi [16,18,19]. From this viewpoint, ADT may decrease the risk of renal calculi.…”

“…Compared with women, males experience two to threefold higher incidences of renal calculi, whose pathogenesis may involve androgen [16][17][18][19]. ADT may alter the risk of renal calculi.…”

Postmenopausal hormone and the risk of nephrolithiasis: a meta-analysis

“…In addition, estrogen use may involve in urinary excretion of kidney stone constituents and of urinary promoters. Elevated levels of serum testosterone and serum dihydrotestosterone might be involved in increased incidences of stone formation (Gupta et al, 2016[ 9 ]). In the clinical trials conducted by Maalouf et al (2010[ 11 ]) PMH use is associated with higher risk of kidney stone formation (Maalouf et al, 2010[ 11 ]).…”