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Testosterone Replacement Therapy in Chronic Kidney Disease Patients. Nutrients 2022; 14:nu14163444. [PMID: 36014950 PMCID: PMC9414796 DOI: 10.3390/nu14163444] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
(Background) The aim of our study was to evaluate the efficacy and safety of testosterone replacement therapy (TRT) in men with chronic kidney disease and hypogonadism on conservative and hemodialysis treatment. (Methods) The studied population consisted of 38 men on hemodialysis (HD), 46 men with CKD stages II-IV (predialysis group, PreD) and 35 men without kidney disease who were similar in age to others (control group). Serum total testosterone level (TT) was measured, and free testosterone level (fT) was calculated. Hypogonadism criteria according to the EAU definition were fulfilled by 26 men on HD (68.4%) and by 24 men from the PreD group (52%). Testosterone replacement therapy (TRT) with testosterone enanthate in intramuscular injections every 3 weeks was applied in 15 men from HD and in 14 men from PreD. The safety of TRT was monitored by measuring PSA and overhydration. (Results) A significant rise of TT and fT was observed after 3 months of TRT, but no significant changes were observed after 6 and 12 months in the HD and PreD group. An intensity of clinical symptoms of hypogonadism measured by ADAM (androgen deficiency in the ageing male) questionnaire gradually decreased, and the intensity of erectile dysfunction measured by the IIEF-5 (international index of erectile functioning) questionnaire also decreased after 3, 6 and 12 months of TRT in the HD and PreD group. (Conclusions) The applied model of TRT is effective in the correction of clinical signs of hypogonadism without a significant risk of overhydration or PSA changes.
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Villasís-Keever MA, Zurita-Cruz JN, Serret-Montoya J, Zepeda-Martinez CDC, Alegria-Torres G, Barradas-Vazquez AS, Hernández-Hernández BC, Alonso-Flores SR, Manuel-Apolinar L, Damasio-Santana L. Leptin receptor and prolactin in pubertal disorders and chronic kidney disease. Pediatr Int 2022; 64:e15183. [PMID: 36348518 DOI: 10.1111/ped.15183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/25/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Knowledge of chronic kidney disease (CKD) with pubertal disorders (PD) in adolescent boys is limited as few studies have explored this disorder. This study aimed to identify the usefulness of assessing hormonal parameters in male adolescents with CKD and their correlation with PD in a 12-month follow-up period. METHODS A prospective cohort study was conducted among male adolescents with CKD (stages IV and V). Data regarding the age at puberty onset were collected from the patients' clinical records and through interview. The patients were followed up for 12 months during their pubertal development. At the beginning, routine hormonal profile tests were performed to examine the patients' thyroid profile, prolactin levels, luteinizing hormone, follicle-stimulating hormone, testosterone, leptin, and receptor leptin. The hormonal profiles of patients with and without PD were compared. Comparisons between the groups were performed using the Student t-test and Fisher's exact tests. Logistic regression analysis was also performed. RESULTS Data of 64 patients (26/64 with PD) were analyzed. The median age was 15 years and the median time for CKD evolution was 11 months. No differences between groups were noted in the general or biochemical characteristics of the patients. The hormonal parameters, prolactin levels were higher and the free leptin and free thyroxine levels were lower in patients with PD. Leptin receptor levels of >0.90 ng/mL (risk ratio [RR], 8.6; P = 0.004) and hyperprolactinemia (RR, 21.3; P = 0.049) were the risk factors for PD. CONCLUSIONS Leptin receptor levels of >0.90 ng/mL and hyperprolactinemia are associated with the development of PD in male adolescents with CKD.
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Affiliation(s)
- Miguel A Villasís-Keever
- Research Unit in Analysis and Synthesis of the Evidence, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jessie N Zurita-Cruz
- Facultad de Medicina Universidad Nacional Autónoma de Mexico, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.,Unit of Research in Medical Nutrition, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Juana Serret-Montoya
- Adolescent Medicine Service, Hospital Infantil de Mexico Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Claudia Del Carmen Zepeda-Martinez
- Department of Pediatric Nephology, Children's Hospital, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Gabriela Alegria-Torres
- Department of Pediatric Nephology, Children's Hospital, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Aly S Barradas-Vazquez
- Unit of Research in Medical Nutrition, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Beatriz C Hernández-Hernández
- Department of Pediatric Nephology, Children's Hospital, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Sara R Alonso-Flores
- Department of Pediatric Nephology, Children's Hospital, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Leticia Manuel-Apolinar
- Endocrine Research Unit, Centro Médico Nacional, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Leticia Damasio-Santana
- Endocrine Research Unit, Centro Médico Nacional, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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