Department of General, Functional and Oncological Urology, Military Institute of Medicine, 04-141 Warsaw, Poland.
Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, 04-141 Warsaw, Poland.
Nutrients. 2022 Aug 22;14(16):3444. doi: 10.3390/nu14163444.
(Background) The aim of our study was to evaluate the efficacy and safety of testosterone replacement therapy (TRT) in men with chronic kidney disease and hypogonadism on conservative and hemodialysis treatment. (Methods) The studied population consisted of 38 men on hemodialysis (HD), 46 men with CKD stages II-IV (predialysis group, PreD) and 35 men without kidney disease who were similar in age to others (control group). Serum total testosterone level (TT) was measured, and free testosterone level (fT) was calculated. Hypogonadism criteria according to the EAU definition were fulfilled by 26 men on HD (68.4%) and by 24 men from the PreD group (52%). Testosterone replacement therapy (TRT) with testosterone enanthate in intramuscular injections every 3 weeks was applied in 15 men from HD and in 14 men from PreD. The safety of TRT was monitored by measuring PSA and overhydration. (Results) A significant rise of TT and fT was observed after 3 months of TRT, but no significant changes were observed after 6 and 12 months in the HD and PreD group. An intensity of clinical symptoms of hypogonadism measured by ADAM (androgen deficiency in the ageing male) questionnaire gradually decreased, and the intensity of erectile dysfunction measured by the IIEF-5 (international index of erectile functioning) questionnaire also decreased after 3, 6 and 12 months of TRT in the HD and PreD group. (Conclusions) The applied model of TRT is effective in the correction of clinical signs of hypogonadism without a significant risk of overhydration or PSA changes.
（背景）我们的研究目的是评估保守治疗和血液透析治疗的慢性肾脏病和性腺功能减退症男性的睾酮替代疗法（TRT）的疗效和安全性。（方法）研究人群包括 38 名血液透析（HD）患者、46 名 CKD Ⅱ-Ⅳ期患者（预透析组，PreD）和 35 名无肾病且年龄与其他患者相似的男性（对照组）。测量血清总睾酮（TT）水平，并计算游离睾酮（fT）水平。根据 EAU 定义，26 名 HD 患者（68.4%）和 24 名 PreD 患者（52%）符合性腺功能减退症标准。在 15 名 HD 患者和 14 名 PreD 患者中应用庚酸睾酮肌内注射每 3 周一次的睾酮替代疗法（TRT）。通过测量 PSA 和过度水化来监测 TRT 的安全性。（结果）TRT 后 3 个月 TT 和 fT 显著升高，但 HD 和 PreD 组 6 个月和 12 个月时无显著变化。应用 ADAM（男性衰老雄激素缺乏）问卷测量的性腺功能减退症临床症状严重程度逐渐降低，应用 IIEF-5（国际勃起功能指数）问卷测量的勃起功能障碍严重程度也在 HD 和 PreD 组 TRT 后 3、6 和 12 个月时降低。（结论）所应用的 TRT 模式可有效纠正性腺功能减退症的临床症状，且无明显过度水化或 PSA 变化的风险。
