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血液透析方案是否会影响终末期肾病患者的血清睾酮水平?

Does the hemodialysis program affect the testosterone serum level in patients with end-stage renal disease?

作者信息

Mustafa Mahmoud, Khaznah Imad, Hrezat Donya, Obaida Lama Abu, Aghbar Amir

机构信息

Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.

Department of Urology, An-Najah National University Hospital, Nablus, 44839, Palestine.

出版信息

Int Urol Nephrol. 2025 Mar;57(3):785-791. doi: 10.1007/s11255-024-04265-5. Epub 2024 Oct 29.

Abstract

PURPOSE

This study aimed to evaluate the effect of high flux membrane hemodialysis on total serum testosterone (TST) levels in male patients with end-stage renal disease (ESRD).

METHODS

The study included 60 male ESRD patients with a mean age of 54.02 ± 13.40 years, undergoing a standard hemodialysis program et al. Najah National University Hospital. All patients underwent three weekly sessions of four hours each using high flux membrane hemodialysis. TST and hematocrit (Hct) levels were measured before and after hemodialysis. Patients with prostate cancer, liver insufficiency, prior prostate surgery, or those on androgen therapy were excluded. The study assessed changes in TST and Hct levels and their correlation.

RESULTS

Post-dialysis, there was a significant increase in serum testosterone levels from 3.13 ± 1.44 ng/ml to 4.17 ± 2.04 ng/ml (r = 0.78, p = 0.001). Hematocrit levels also rose significantly from 32.31% ± 3.90% to 35.27% ± 4.89% (r = 0.754, p = 0.001). The percentage change in TST and Hct levels was 35 ± 0.33% and 9 ± 0.1%, respectively, with a correlation between these changes (r = 0.277, p = 0.032).

CONCLUSION

High flux membrane dialysis did not filter testosterone molecules, and the significant increase in TST levels post-dialysis is likely due to hemoconcentration. Since many patients had low or borderline TST levels before dialysis, androgen supplementation may offer clinical benefits.

摘要

目的

本研究旨在评估高通量膜血液透析对终末期肾病(ESRD)男性患者血清总睾酮(TST)水平的影响。

方法

该研究纳入了60名平均年龄为54.02±13.40岁的男性ESRD患者,他们在纳吉赫国立大学医院接受标准血液透析治疗等。所有患者每周进行三次,每次四小时的高通量膜血液透析。在血液透析前后测量TST和血细胞比容(Hct)水平。排除患有前列腺癌、肝功能不全、既往前列腺手术史或正在接受雄激素治疗的患者。该研究评估了TST和Hct水平的变化及其相关性。

结果

透析后,血清睾酮水平从3.13±1.44 ng/ml显著增加至4.17±2.04 ng/ml(r = 0.78,p = 0.001)。血细胞比容水平也从32.31%±3.90%显著升至35.27%±4.89%(r = 0.754,p = 0.001)。TST和Hct水平的百分比变化分别为35±0.33%和9±0.1%,这些变化之间存在相关性(r = 0.277,p = 0.032)。

结论

高通量膜透析未滤过睾酮分子,透析后TST水平显著升高可能是由于血液浓缩。由于许多患者在透析前TST水平较低或处于临界值,补充雄激素可能具有临床益处。

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