The effect of maintenance haemodialysis and renal transplantation on the plasma testosterone levels of male patients in chronic renal failure.

Plasma testosterone levels were measured at the beginning of a 14 h period of haemodialysis, one hour later, midway through the period and at the end, in 18 male patients in chronic renal failure. The level fell from 8.70 +/- 2.63 nmol/l at the start to 8.08 +/- 3.33 nmol/l at the midpoint, and rose again to 10.12 +/- 3.9 nmol/l at the end of a dialysis. All seven of the patients tested on a non-dialysis day showed similar levels at the same time. At the beginning of a 10 h dialysis period 19 other male patients showed a plasma testosterone level of 10.12 +/- 3.99 nmol/l and, at the end, of 8.98 +/- 4.54 nmol/l. Over the same period the plasma corticosteroids rose from 301 +/- 101 nmol/l to 483 +/- 199 nmol/l. Eight male patients who had had successful renal transplantation had plasma testosterone levels of 15.08 +/- 7.49 nmol/l. It is concluded that the plasma testosterone is low in chronic renal failure, but the circadian rhythm is preserved. Treatment with maintenance haemodialysis does not itself affect the plasma testosterone level, or alter the circadian rhythm despite the procedure's being a stress. Successful renal transplantation restores the plasma testosterone to normal in most cases.