Department of Urology, Inje University, Seoul Paik Hospital, Seoul, Korea.
Department of Nephrology, Inje University, Seoul Paik Hospital, Seoul, Korea.
Am J Mens Health. 2020 May-Jun;14(3):1557988320917258. doi: 10.1177/1557988320917258.
Testosterone deficiency (TD) is common and impairs quality of life (QoL) in patients with chronic kidney disease (CKD). However, there are no studies about whether testosterone replacement therapy (TRT) can improve QoL in patients with CKD. Therefore, we investigated the effect of TRT on the QoL of patients with CKD and confirmed the safety of TRT. Twenty-five male patients with stages III-IV CKD whose serum testosterone levels were <350 ng/dl (TD) were enrolled and treated with testosterone gel for 3 months (group II). Age-matched controls with stages III-IV CKD and TD (group I) were recommended to exercise for the same period. Before and after the treatment, the BMI and handgrip strength were checked, serological tests were performed, and questionnaires were administered in both groups. Compared to baseline, there was no significant difference in serum testosterone levels, scores of the 36-Item Short Form Health Survey (SF-36), Aging Males' Symptoms Scale (AMS), and International Prostate Symptom Score (IPSS), and grip strength in group I after 3 months. In group II, a significant increase in testosterone, hemoglobin (Hb), and hematocrit (Hct) was observed, and grip strength significantly increased after TRT. Significant improvement in scores of SF-36, AMS, and IPSS was also confirmed after TRT in group II. There was a significant difference in testosterone, Hb, Hct, grip strength, and scores of SF-36, AMS, and IPSS between the two groups after 3 months. The patients in group II showed positive results and continued with TRT. Therefore, we conclude that TRT safely improves the QoL and TD symptoms in patients with moderate-to-severe CKD.
睾酮缺乏症（TD）在慢性肾脏病（CKD）患者中很常见，并会损害其生活质量（QoL）。然而，目前尚无研究探讨睾酮替代治疗（TRT）是否可以改善 CKD 患者的 QoL。因此，我们研究了 TRT 对 CKD 患者 QoL 的影响，并证实了 TRT 的安全性。我们招募了 25 名血清睾酮水平<350ng/dl（TD）的 III-IV 期 CKD 男性患者，并使用睾酮凝胶治疗 3 个月（II 组）。年龄匹配的 III-IV 期 CKD 伴 TD 的对照组（I 组）建议在同一时期进行运动。在治疗前后，检查两组的 BMI 和握力，进行血清学检查，并在两组中进行问卷调查。与基线相比，I 组治疗 3 个月后血清睾酮水平、36 项简明健康调查（SF-36）评分、男性衰老症状量表（AMS）评分和国际前列腺症状评分（IPSS）以及握力均无显著差异。在 II 组中，观察到睾酮、血红蛋白（Hb）和血细胞比容（Hct）显著增加，TRT 后握力显著增加。TRT 后还证实了 II 组的 SF-36、AMS 和 IPSS 评分显著改善。治疗 3 个月后，两组间的睾酮、Hb、Hct、握力和 SF-36、AMS 和 IPSS 评分差异均有统计学意义。II 组患者表现出积极的结果，并继续接受 TRT。因此，我们得出结论，TRT 可安全改善中重度 CKD 患者的 QoL 和 TD 症状。
