Serum testosterone concentration in male patients with end-stage kidney disease treated with haemodialysis

Introduction: Testosterone deficiency is one of the complications found in male patients with chronic kidney disease (CKD) and may participate in the pathogenesis of osteoporosis, sarcopenia, anemia, impotence, infertility, and other comorbidities observed in these patients. The aim of the study was the evaluation of the frequency of testosterone deficiency in male patients with CKD on maintenance hemodialysis (HD). Materials and methods: In 79 male HD patients serum total (TT) and free (FT) testosterone, C-reactive protein (CRP) and interleukin - 6 (IL - 6) serum concentrations were assessed before HD procedure. Patients were divided into three subgroups based on age categories: 19 - 39 years (18 patients), 40 - 59 years (34 patients) and ≥60 years (27 patients), respectively. TT insufficiency and deficiency were diagnosed when serum TT concentration was below 4.0 ng/ml and 2.9 ng/ml, respectively. FT deficiency was diagnosed in patients with serum FT concentration below 8.9, 6.6 and 4.9 pg/ml in above mentioned age subgroups, respectively. Results: In above mentioned age subgroups serum TT concentration was 5.9 (4.6 - 7.1), 4.8 (3.9 - 5.4), 4.6 (3.9 - 5.3) ng/ml, respectively. Serum FT concentration was 7.9 (5.2 - 10.1), 6.1 (5.1 - 7.2) and 6.0 (5.0 - 7.1) pg/ml, respectively. In the whole group TT insufficiency was found in 40%, and TT deficiency in 15% of patients, FT deficiency was found in 50% of patients. Significant negative correlations were found between both serum TT and FT concentrations and age (r= -0.23, p= 0.05 and r= -0.27, p= 0.02), respectively. Additionally, negative correlations were found between both serum TT and FT and IL - 6 concentrations (r= -0.43, p<0.05 and r= -0.29, p<0.05), respectively. Conclusions: 1. Testosterone deficiency is common in male patients with chronic kidney disease treated with HD. 2. In HD patients serum testosterone concentration decreases with age. 3. Chronic inflammation may participate in pathogenesis of testosterone deficiency in haemodialysis patients.