Testosterone deficiency in dialysis patients: Differences according to the dialysis techniques

Cigarrán, Secundino; Coronel, Francisco; Florit, Enrique; Calviño, Jesús; Villa, Juan; Tabarés, Lourdes González; Herrero, José Antonio; Carrero, Juan Jesús

doi:10.1016/j.nefroe.2017.09.005

Cited by 8 publications

(12 citation statements)

References 13 publications

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“…There was no inadequacy of dialysis in either the PD or HD groups. A study evaluating the effect of HD adequacy on testosterone levels by Kim and colleagues demonstrated no significant difference in terms of testosterone levels between the groups with and without HD adequacy (12). As in the study of Kim et al, this study was demonstrated that dialysis adequacy was not associated with serum testosterone levels.…”

Section: Discussionsupporting

confidence: 57%

The effects of dialysis modalities on sexual hormone levels in male patients

Atilgan¹,

Aylı²,

Yalcindag³

et al. 2020

Journal of Health Sciences and Medicine

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Amaç: Düşük testosteron düzeyi, kardiyovasküler risk faktörleri ve düşük yaşam kalitesi ile ilişkilidir. Diyalizin testosteron düzeyi üzerine etkisi halen net değildir. Amaç hemodiyaliz (HD) ve periton diyalizi (PD) tekniklerinin erkek cinsel hormonları üzerine etkisinin araştırmaktır. Gereç ve Yöntem: Serum total testosteron (TT), serbest testosteron (ST), follikül stimulan hormon (FSH), luteinizan hormon (LH), prolaktin (PRL) and seks hormone bağlayıcı globulin (SHBG) incelendi. Serum TT, 3 ng/ml'nin altında ise düşük TT düzeyi kabul edildi. Sosyodemografik veriler ve günlük yaşam aktivitesinde bağımsız olabilme indeksi kaydedildi. Bulgular: Çalışmaya erişkin erkek HD (n=71) ve PD (n=24) hastaları dahil edildi. Her iki grubun yaş ve diyaliz süreleri benzerdi. Serum TT ve ST düzeyleri anlamlı düzeyde PD grubunda yüksek idi (p=0.01 and p=0.05, respectively). PD ve HD grupları arasında SHBG, FSH, LH veya PRL düzeyleri açısından farklılık yoktu (p=0.353, p=0.858, p=0.410 and p=0.410, sırasıyla). Günlük yaşam aktivitesinde bağımsız olabilme indeksi aktivitelerini gerçekleştiren hasta sayısı PD grubu (p=0.033) ve normal TT düzeyli grupta (p=0.027) daha fazlaydı. Binary regresyon analizinde, PD grubunda testosteron düzeyine etkinin daha olumlu olduğu gösterilmiştir (OR=4.659; 1.477-14.704 95% CI Exp B). Sonuç: Periton diyalizinin HD ile karşılaştırıldığında testosteron düzeyleri üzerine olumlu etkisi vardır. PD tekniğinin kendisi ve sağladığı fiziksel ve zihinsel iyilik hali testosteron düzeylerini etkilemektedir.

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Section: Discussionsupporting

confidence: 57%

The effects of dialysis modalities on sexual hormone levels in male patients

Atilgan¹,

Aylı²,

Yalcindag³

et al. 2020

Journal of Health Sciences and Medicine

View full text Add to dashboard Cite

show abstract

“…In a cross-sectional study of 79 male patients, Cigarrán et al showed that patients receiving PD maintained higher testosterone levels than patients receiving HD; testosterone deficiency (<3 ng/mL) was observed in 39.5% of patients receiving HD compared with 5.6% of patients receiving PD. To date, this is one of the few studies to correlate RRT technique with the development of hypogonadism [ 104 ].…”

Section: Introductionmentioning

confidence: 99%

Multifaceted Sexual Dysfunction in Dialyzing Men and Women: Pathophysiology, Diagnostics, and Therapeutics

Chou

Kiebalo

Jagiello

et al. 2021

Life

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Patient survival continues to increase with the growing quality of dialysis and management of chronic kidney disease (CKD). As such, chronic therapy must include considerations of quality of life (QOL), and this includes the disproportionate prevalence of sexual dysfunction (SD) in this patient population. This review aims to describe the pathophysiological and the psychosocial causes of SD with regard to renal replacement therapy, particularly hemo- and peritoneal dialysis. The differences in its manifestation in men and women are compared, including hormonal imbalances—and therefore fertility, libido, and sexual satisfaction—the experience of depression and anxiety, and QOL. The impact of comorbidities and the iatrogenic causes of SD are described. This review also presents validated scales for screening and diagnosis of SD in CKD patients and outlines novel therapies and strategies for the effective management of SD. Increased prevalence of CKD invariably increases the number of patients with SD, and it is crucial for health care professional teams to become familiar with the clinical tools used to manage this sensitive and under-quantified field. As a known predictor of QOL, sexual function should become a point of focus in the pursuit of patient-centered care, particularly as we seek to achieve as “normal” a life as possible for individuals who receive dialysis.

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“…19,20 We have shown that testosterone stimulates iron-dependent erythropoiesis in mice and in humans. [8][9][10][11] We further demonstrated that testosterone suppresses hepcidin transcription by disrupting BMP/Smad signaling, 21,22 and increases iron availability and iron incorporation into the erythroid cells. 22 However, additional experiments revealed that testosterone administration significantly increased hemoglobin and red cell counts even in mice with genetic disruption of the hepcidin gene.…”

Section: Introductionmentioning

confidence: 60%

“…[1][2][3][4][5][6] Testosterone corrects unexplained anemia of the elderly, anemia of inflammation, and anemia of chronic kidney disease. 1,4,[7][8][9][10][11] However, the mechanisms by which testosterone stimulates erythropoiesis remain incompletely understood. 3,[12][13][14][15][16] Several hypothesis have been proposed to explain the effects of testosterone on erythropoiesis, including stimulation of erythropoietin production; direct effects on erythroid progenitor cells; increased progenitor sensitivity to erythropoietin, 17,18 as well as increased iron availability.…”

Section: Introductionmentioning

confidence: 99%

“…Testosterone increases hemoglobin, hematocrit, and circulating red cell counts in a dose‐dependent manner 1‐6 . Testosterone corrects unexplained anemia of the elderly, anemia of inflammation, and anemia of chronic kidney disease 1,4,7‐11 . However, the mechanisms by which testosterone stimulates erythropoiesis remain incompletely understood 3,12‐16 …”

Section: Introductionmentioning

confidence: 99%

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The role of iron in mediating testosterone's effects on erythropoiesis in mice

et al. 2020

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Testosterone stimulates iron‐dependent erythropoiesis and suppresses hepcidin. To clarify the role of iron in mediating testosterone's effects on erythropoiesis, we induced iron deficiency in mice by feeding low iron diet. Iron‐replete and iron‐deficient mice were treated weekly with testosterone propionate or vehicle for 3 weeks. Testosterone treatment increased red cell count in iron‐replete mice, but, surprisingly, testosterone reduced red cell count in iron‐deficient mice. Splenic stress erythropoiesis was stimulated in iron‐deficient mice relative to iron‐replete mice, and further increased by testosterone treatment, as indicated by the increase in red pulp area, the number of nucleated erythroblasts, and expression levels of TfR1, GATA1, and other erythroid genes. Testosterone treatment of iron‐deficient mice increased the ratio of early‐to‐late erythroblasts in the spleen and bone marrow, and serum LDH level, consistent with ineffective erythropoiesis. In iron‐deficient mice, erythropoietin levels were higher but erythropoietin‐regulated genes were generally downregulated relative to iron‐replete mice, suggesting erythropoietin resistance. Conclusion: Testosterone treatment stimulates splenic stress erythropoiesis in iron‐replete as well as iron‐deficient mice. However, testosterone worsens anemia in iron‐deficient mice because of ineffective erythropoiesis possibly due to erythropoietin resistance associated with iron deficiency. Iron plays an important role in mediating testosterone's effects on erythropoiesis.

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Testosterone deficiency in dialysis patients: Differences according to the dialysis techniques

Cited by 8 publications

References 13 publications

The effects of dialysis modalities on sexual hormone levels in male patients

The effects of dialysis modalities on sexual hormone levels in male patients

Multifaceted Sexual Dysfunction in Dialyzing Men and Women: Pathophysiology, Diagnostics, and Therapeutics

The role of iron in mediating testosterone's effects on erythropoiesis in mice

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