Parathyroid hormone, prolactin, and function of the pituitary-gonadal axis in male patients with acute renal failure.

In 26 patients with acute renal failure (ARF), plasma levels of lutropin (LH), folitropin (FSH), prolactin, testosterone, estradiol, and parathyroid hormone (PTH) were studied at the anuric/oliguric (AOP) and polyuric phase. Significantly elevated levels of LH, FSH, and prolactin were found during the AOP. Administration of luliberin (LH-RH) was followed by normal or even excessive and prolonged increase of plasma LH and FSH levels during the AOP. Basal plasma testosterone was significantly depressed, but estradiol was moderately elevated at the AOP. Administration of LH-RH did not influence significantly either testosterone or estradiol levels in blood plasma. A negative correlation was found between plasma prolactin and testosterone, and a positive one was found between prolactin and estradiol at the AOP of ARF. In contrast to chronic renal failure, PTH was not significantly correlated with either plasma testosterone or prolactin. We conclude that the hyporesponsiveness of Leydig's cell to the LH signal is the cause of depressed testosterone biosynthesis. It seems probable that prolactin, but not PTH, is involved in the pathogenesis of testicular dysfunction in patients with ARF.