Low serum testosterone levels and the incidence of chronic kidney disease among male adults: A prospective population based study.
Amiri M, et al. Andrology. 2019.
BACKGROUND: Despite existing evidence regarding the role of testosterone as a protective factor for the kidney function in male adults, there are conflicting and inconclusive results on the influence of testosterone deficiency on developing chronic kidney disease (CKD).
OBJECTIVE: This study aimed to investigate the incidence and hazard ratio of CKD among male adults with low testosterone levels compared to controls with normal testosterone levels.
MATERIALS AND METHODS: During a 15-year follow-up study, a total of 1277 eligible male adults aged 20-80 years consisting of 605 males with low testosterone levels (< 350 ng/dL) and 672 controls with normal levels participating in the Tehran-Lipid and Glucose Study were recruited. Cox’s proportional hazards models were applied to estimate hazard ratios of CKD between the groups after adjusting for confounders.
RESULTS: The total cumulative incidence rate of CKD at the median follow-up time of approximately 11.2 years was 21/1000 (95% CI: 18/1000, 25/1000) and 18/1000 (95% CI: 16/1000, 22/1000) in the low and normal testosterone groups, respectively (P = .2). The multivariate Cox model adjusted for age, body mass index, dyslipidemia, hypertension, diabetes, and smoking showed that HR of developing CKD in the male adults with low testosterone levels was significantly higher than those with normal levels (HR = 1.38; 95% CI: 1.05, 1.80).
DISCUSSION AND CONCLUSION: This study shows a higher hazard ratio of CKD progression in male adults with hypogonadism compared to those with normal levels in their later life. Therefore, timely diagnosis and treatment of kidney diseases in hypoganadal men can prevent the morbidity and mortality from CKD.