Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, 128 Szaserów Street, 04-141 Warsaw, Poland.
Nutrients. 2022 Aug 21;14(16):3438. doi: 10.3390/nu14163438.
Reduced testosterone concentration is nowadays thought to be one of the main endocrine disorders in chronic kidney disease (CKD). It is caused by the dysfunction of the hypothalamic-pituitary-gonadal axis. The role of testosterone is multifactorial. Testosterone is responsible not only for reproductive processes, but it is a hormone which increases bone and muscle mass, improves lipid profile, insulin sensitivity, erythropoiesis, reduces blood pressure, and ameliorates mood and perception. The implications of hypogonadism in CKD are infertility and loss of libido, reduction of muscle mass and strength, disorders in bone mineralization, the development of sarcopenia and protein energy wasting (PEW), progression of atherosclerosis, increased visceral adiposity, insulin resistance, and anaemia. Reduced testosterone serum concentrations in CKD are associated with increased mortality rate. Testosterone supplementation improves sexual functions, reduces the level of inflammatory markers and blood pressure, stimulates muscle protein synthesis, improves insulin sensitivity and lipid profile, and increases muscle mass, bone mineral density, and haemoglobin concentration. It positively affects mood and well-being. The modes of testosterone supplementation are intramuscular injections, subcutaneous pellets, and percutaneous methods-patches and gels. Successful kidney transplantation may improve gonadal function and testosterone production, however, half of men with low testosterone concentrations before kidney transplantation do not restore hormonal function.
如今，人们认为睾丸酮浓度降低是慢性肾脏病（CKD）的主要内分泌紊乱之一。它是由下丘脑-垂体-性腺轴功能障碍引起的。睾丸酮的作用是多方面的。睾丸酮不仅负责生殖过程，还是一种增加骨量和肌肉量、改善血脂谱、提高胰岛素敏感性、促进红细胞生成、降低血压以及改善情绪和认知的激素。性腺功能减退症在 CKD 中的影响包括不孕和性欲降低、肌肉量和力量减少、骨矿物质化紊乱、发生肌肉减少症和蛋白质能量消耗（PEW）、动脉粥样硬化进展、内脏脂肪增加、胰岛素抵抗和贫血。CKD 患者血清睾丸酮浓度降低与死亡率增加有关。睾丸酮补充治疗可改善性功能，降低炎症标志物和血压水平，刺激肌肉蛋白合成，改善胰岛素敏感性和血脂谱，增加肌肉量、骨密度和血红蛋白浓度。它还可以积极改善情绪和健康状况。睾丸酮补充的方式有肌肉内注射、皮下埋植剂和经皮贴剂和凝胶。成功的肾移植可能会改善性腺功能和睾丸酮生成，但一半在肾移植前睾丸酮浓度低的男性并未恢复激素功能。
