Nephrol Dial Transplant (2002) 17: 368-371
© 2002 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Sexual hormone abnormalities in male patients with renal failure
1 Division of Nephrology and Dialysis and 2 Division of Endocrinology, Department of Internal Medicine III, University of Vienna, Vienna, Austria
Introduction
Endocrine abnormalities are a common feature of chronic renal insufficiency [1,2]. Changes of androgen synthesis and metabolism develop early after the onset of renal insufficiency and are likely to be caused by primary hypogonadism and/or disturbances of the hypothalamicpituitary axis. Uraemic toxins, co-morbidity, and concomitant drug administration are supposed to contribute to the observed changes, yet the exact mechanism remains unclear. Impaired function of the hypothalamicpituitarygonadal axis is not reversed by initiation of otherwise effective haemodialysis or peritoneal dialysis therapy. In contrast, renal transplantation was reported to restore endocrine function, but study results are conflicting. A complete normalization as well as persistingly low testosterone levels have been described after transplantation and gonadotrophin levels were also reported to be persistingly high or normal [3,4].
Pathophysiology and pathogenesis
In male patients with renal failure, plasma testosterone levels are decreased or in the low normal range in the
Aetiology
Consequences of androgen deficit
Therapy
Side effects of androgen therapy
Progression of renal disease by androgens?
Notes
References
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