Serum Anti-Müllerian Hormone Concentration in Young Women with Chronic Kidney Disease on Hemodialysis, and After Successful Kidney Transplantation

Abstract

Background/Aims: In women with chronic kidney disease (CKD) fertility abnormalities occur frequently. Anti-Müllerian hormone (AMH) inhibits excessive recruitment of primordial follicles. The aim of the study was to evaluate the serum AMH concentration in women on hemodialysis and after kidney transplantation (KTx). Methods: 46 hemodialysed women and 14 with CKD about to undergo kidney transplantation were enrolled into the study. The control group consisted of 40 healthy women. In all subjects serum concentration of AMH was determined (in chronic hemodialysis women and in control group once, and in women after KTx immediately before surgery, and 3 times after the transplantation). Results: Serum AMH concentration in hemodialysed women and in the control group did not differ significantly, while in hemodialysed women with regular menstrual cycles it was significantly lower than in the control group: 2.20 (1.08-3.55ng/ml) and 3.30 (1.80-6.10ng/ml) respectively, (p=0.02). In the KTx group, a significant decrease in serum AMH concentration was found from 3.30ng/ml (2.20-6.50ng/ml) at baseline to 1.90ng/ml (1.30-2.40ng/ml) at 6 months after KTx (p=0.007). Conclusions: 1. Significantly lower serum AMH concentration was found in the regularly menstruating CKD women on hemodialysis in comparison with the healthy controls. 2. Serum AMH decreased significantly after successful KTx.

Hypothyroidism and AMH in Iraqi Patients with Chronic Kidney Disease

“…Results of this study go in agreement with those that have been found with (15), who showed that CKD patients were found to have nonsignificant increase in AMH concentrations compared with control. The results of this study were compatible with data reported by (14), who found that serum AMH concentration was higher in haemodialysed women with CKD and had menstrual cycle abnormalities in comparison to those with regular menstrual cycles, and suggested that serum AMH clearance is reduced in CKD patients and AMH similar to other protein hormones probably accumulates in those patients (16). On the other hand, AMH is of similar size to other molecules perceived to be uremic 'toxins' (17).…”

“…CKD and its consequences affect the production of AMH, resulting in change in plasma AMH levels, this may indicate impaired function of Sertoli cells (13). In women with CKD the aforementioned fertility disturbances may be caused by the damage of the ovaries by uremia, this may reflect an intrinsic dysregulation of the granulosa cells leading to higher AMH production or alternatively AMH accumulation in ESRD requiring dialysis (14,15).…”

The utility of anti-Müllerian hormone in women with chronic kidney disease, on haemodialysis and after kidney transplantation

“…Conversely, fertility is frequently restored within a few months after successful kidney transplantation (Levidiotis et al, 2009). To date we are only aware of a single small study (n = 60) assessing AMH in patients with renal failure (Sikora-Grabka et al, 2016). This study utilized a manual AMH ELISA, which was limited by complement interference, irreproducible results and limited sensitivity (Iliodromiti et al, 2015).…”

Exclusion of pregnancy in dialysis patients: diagnostic performance of human chorionic gonadotropin

“…In dialysis patients, an elevation of FSH concentrations also indicates true menopause [14]. Serum AMH concentrations were found to be similar in dialysis patients and healthy controls [16,17] and thus we used low AMH concentrations to ascertain infertility in selected cases. We also described LH serum concentrations, which are usually elevated in case of menopausal transition, infertility or in dialysis patients [18,19].…”