International Journal of Nephrology and Renovascular Disease (Nov 2020)
Advanced Chronic Kidney Disease is a Strong Predictor of Hypogonadism and is Associated with Decreased Lean Tissue Mass
Abstract
Ryszard Skiba,1 Anna Matyjek,2 Tomasz Syryło,1 Stanisław Niemczyk,2 Aleksandra Rymarz2 1Department of General, Functional and Oncological Urology, Military Institute of Medicine, Warsaw, Poland; 2Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, PolandCorrespondence: Ryszard SkibaDepartment of General, Functional and Oncological Urology Military Institute of Medicine, Szaserów, 128 04-141, Warsaw, PolandTel +48 692 916 963Fax + 48 22 810 31 74Email [email protected]: In patients with chronic kidney disease (CKD), hypogonadism is more frequent than in the general population and its prevalence ranges between 40% and 60%. The aim of the study was to investigate the prevalence of hypogonadism and its association with kidney function, body composition, inflammatory markers and lipid disorders in patients with CKD.Materials and Methods: The study population consisted of 112 men aged ≥ 40 years in different stages of CKD: 33 participants with eGFR ≥ 60 mL/min/1.73 m2, 27 men with eGFR 30– 59 mL/min/1.73 m2, 17 predialysis patients with eGFR < 30 mL/min/1.73 m2, and 35 men on hemodialysis therapy three times a week for more than 3 months (G5D stage). Total testosterone (TT) levels were measured and free testosterone (FT) levels were calculated. Body composition was assessed using bioimpedance spectroscopy (Body Composition Monitor, FMC). Statistical analysis was performed using Statistica version 13.1.Results: CKD stage was a strong predictor of hypogonadism (providing an information value of 0.83). The weight of evidence technique allowed us to differentiate the high-risk group, which was a group of patients with advanced CKD, defined as eGFR < 30 mL/min/1.73 m2. In this group, the likelihood of hypogonadism was 69.23%. Another significant predictor of hypogonadism was lean tissue index (LTI). TT and FT levels were significantly lower in the advanced CKD group in comparison to the control group, whereas prolactin, luteinizing hormone and C-reactive protein levels were significantly higher in the advanced CKD group. The LTI was significantly lower in advanced CKD and was positively correlated with TT and FT.Conclusion: Decreased eGFR and decreased LTI are predictors of hypogonadism associated with CKD. The study results suggest that hypogonadism screening should be carried out when eGFR deceases below 30 mL/min/1.73 m2.Keywords: total testosterone, free testosterone, hypogonadism, chronic kidney disease, lean tissue index
