A comparison of hemodialysis and transplantation in reversing the uremic disturbance of male reproductive function.

A comparative study of the capacity of maintenance hemodialysis and renal transplantation to reverse the uremic damage to testicular function in 27 men with chronic renal failure was performed over a two year period. Despite two years of stable hemodialysis there was only minor improvement in sexual activity. Testosterone levels failed to improve and luteinising hormone (LH) levels remained high. Elevation of serum follicle stimulating hormone (FSH) together with severe spermatogenic damage persisted. Transplant patients showed a significant improvement in sexual activity, a return of testosterone to normal, and a significant fall in LH levels. Fertility, as assessed by sperm count, was improved in 50% of transplant patients. Thus while renal transplantation may restore reproductive function in men with chronic renal failure maintenance hemodialysis has no effect.