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Testosterone deficiency in men with end stage renal disease and kidney transplantation: a narrative review

International Journal of Impotence Research (2024)Cite this article

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Abstract

Testosterone deficiency is a prevalent condition that frequently affects individuals with end-stage renal disease (ESRD) and those who have undergone renal transplantation. While the etiology of this condition is complex, its implications in this population are far-reaching, impacting various domains such as endocrine profile, sexual and erectile function, bone mineral density (BMD), anemia, and graft survival following renal transplantation. Herein, we review the most recent literature exploring the pathophysiology of testosterone deficiency in ESRD and renal transplant patients, examining its diverse effects on this demographic, and assessing the advantages of testosterone replacement therapy (TRT). Existing evidence suggests that TRT is a safe intervention in ESRD and renal transplant patients, demonstrating improvements across multiple domains. Despite valuable insights from numerous studies, a critical need persists for larger, high-quality prospective studies to comprehensively grasp the nuances of TRT, especially in this vulnerable population. Proactive screening and treatment of testosterone deficiency may prove beneficial, emphasizing the urgency for further research in this area.

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Fig. 1: Impact of CKD/ESRD on testosterone and subsequent effects.
Fig. 2: TRT on CKD and renal transplantation.

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Authors and Affiliations

  1. Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Nicholas A. Deebel

  2. Division of Urology, Virginia Commonwealth University, Richmond, VA, USA

    Ashley N. Matthew

  3. Department of Urology, Montefiore Medical Center, Bronx, NY, USA

    Justin Loloi

  4. New York University Langone Health, Department of Urology, New York, NY, USA

    Ari P. Bernstein

  5. Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Nannan Thirumavalavan

  6. Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL, USA

    Ranjith Ramasamy

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Research conception and design: ND. Drafting of the manuscript: all authors. Critical revision of the manuscript: all authors. Supervision: RR Approval of the final manuscript: all authors.

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Correspondence to Ranjith Ramasamy.

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Dr. Nannan Thirumavalavan is the recipient of the 2021 Young Clinicians Grant from the Sexual Medicine Society of North America. We otherwise declare no competing interests.

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Deebel, N.A., Matthew, A.N., Loloi, J. et al. Testosterone deficiency in men with end stage renal disease and kidney transplantation: a narrative review. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00890-x

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