Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Urologia. 2023 May;90(2):272-277. doi: 10.1177/03915603231162394. Epub 2023 Apr 3.
Vitamin D's role is noticeable on homeostasis of calcium and phosphorous and bone mineralization. Some studies prove that vitamin D has a role in reproductive pathways in male and females and its direct relationship with serum androgen levels in males. The common problem of infertility can be seen in 10%-15% of couples. 25%-50% of all infertilities is due to a male factor, and fertility disturbances are common in male CKD patients.
This study aimed to figure out the effect of serum vitamin D levels on semen analysis parameters and reproductive hormones before and after renal transplantation in ESRD patients.
This double-blind randomized clinical trial was carried out on 70 ESRD males (21-48 years old) who were candidates for renal transplantation at Sina hospital between 2021 and 2022. Participants were divided into two groups randomly. First group was supplemented by vitamin D (50,000 units weakly until 3 months), and no intervention was done in the second group. Vitamin D levels, LH, FSH, creatinine, glomerular filtration rate (GFR), calcium, total and free testosterone, PTH, sexual function, and semen analysis parameters were evaluated in a determined interval before and after (three and 6 months) kidney transplantation.
Vitamin D levels were noticeably higher in case group in comparison to the control group (-value < 0.01) but the difference in all other variables including calcium levels, LH, FSH, total and free testosterone, IIEF-5 score, PTH, GFR, and creatinine was insignificant (-value > 0.05). The comparison of semen parameters of the case with control group including sperm count, morphology, volume, and motility didn't reveal a noticeable difference between the two groups (-value > 0.05).
Prescription of vitamin D as a supplementation doesn't improve sperm quality (sperm count, motility, morphology, and volume) and reproductive hormones (LH, FSH, free and total testosterone) after kidney transplantation in male CKD patients.
维生素 D 对钙和磷的体内平衡和骨骼矿化有显著作用。一些研究证明，维生素 D 在男性和女性的生殖途径中发挥作用，并且与男性血清雄激素水平直接相关。在 10%-15%的夫妇中可以看到常见的不孕问题。所有不孕的 25%-50%归因于男性因素，男性慢性肾脏病患者的生育障碍很常见。
本研究旨在探讨血清维生素 D 水平对终末期肾病患者肾移植前后精液分析参数和生殖激素的影响。
本双盲随机临床试验于 2021 年至 2022 年在 Sina 医院对 70 名终末期肾病男性（21-48 岁）进行，这些男性是肾移植的候选人。参与者被随机分为两组。第一组补充维生素 D（50,000 单位弱，直至 3 个月），第二组不进行干预。在肾移植前（3 个月和 6 个月）和后评估维生素 D 水平、LH、FSH、肌酐、肾小球滤过率（GFR）、钙、总睾酮和游离睾酮、甲状旁腺激素、性功能和精液分析参数。
与对照组相比，病例组的维生素 D 水平明显升高（-值<0.01），但其他所有变量（包括钙水平、LH、FSH、总睾酮和游离睾酮、IIEF-5 评分、PTH、GFR 和肌酐）的差异均无统计学意义（-值>0.05）。病例组与对照组精液参数的比较，包括精子计数、形态、体积和活力，两组之间没有明显差异（-值>0.05）。
在男性慢性肾脏病患者肾移植后，维生素 D 的处方作为补充剂不能改善精子质量（精子计数、活力、形态和体积）和生殖激素（LH、FSH、游离和总睾酮）。
