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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

Alice Schmidt1,, Anton Luger2 and Walter H. Hörl1

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 hypothalamic–pituitary 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 hypothalamic–pituitary–gonadal 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 . . . [Full Text of this Article]

Aetiology

Consequences of androgen deficit

Therapy

Side effects of androgen therapy

Progression of renal disease by androgens?

Notes

References


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