The effects of dialysis modalities on sexual hormone levels in male patients

Year 2020, Volume: 3 Issue: 2, 166 - 171, 19.03.2020

Kadir Gökhan Atılgan Mehmet Deniz Aylı Ali Yalcindağ Fatih Yay Ebru Gök Oğuz Gülay Ulusal Okyay Fatma Ayerden Ebinç

https://doi.org/10.32322/jhsm.685394

Abstract

Introduction:
Low testosterone level is association with low quality of life and cardiovascular risk factors. The dialysis modality effects on testosterone levels remain unclear. To investigate the haemodialysis (HD) and peritoneal dialysis (PD) effects on male sexual hormones.
Material and Method:
Serum total testosterone (TT), free testosterone (FT), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and sex hormone-binding globulin (SHBG) were investigated. Serum TT below 3 ng/ml was considered a low TT. Sociodemographic data and an Index of Independence in Activities of Daily Living were recorded.
Results:
This study included adult male HD (n = 71) and PD (n = 24) patients. Age and dialysis duration were similar between groups. Serum TT and FT levels were significantly higher in the PD group (p = 0.01 and p = 0.05, respectively). There were no differences between the HD and PD groups with regard to SHBG, FSH, LH or PRL levels (p = 0.353, p = 0.858, p = 0.410 and p = 0.410, respectively). The number of patients who were capable of performing Index of Independence in Activities of Daily Living was higher in the PD group (p = 0.033) and with normal TT levels (p = 0.027). Binary regression analysis showed more favourable effects in the PD group on testosterone levels (OR = 4.659; 1.477–14.704 95% CI Exp B).
Conclusion:
PD has favourable effects on testosterone levels compared to HD. Mental and physical well being resulting from PD and its technique affect TT levels.

Keywords

chronic renal failure, haemodialysis, peritoneal dialysis, testosterone, index of independence in daily living activities

References

• 1. Schmidt A, Luger A, Horl WH. Sexual hormone abnormalities in male patients with renal failure. Nephrol Dial Transplant 2002 17:368-71.
• 2. Handelsman DJ, Spaliviero JA, Turtle JR. Testicular function in experimental uremia. Endocrinology 1985 117:1974-83.
• 3. Eckersten D, Giwercman A, Pihlsgard M, et al. Impact of Kidney Transplantation on Reproductive Hormone Levels in Males: A Longitudinal Study. Nephron 2018 138:192-201.
• 4. Shoskes DA, Kerr H, Askar M, et al. Low testosterone at time of transplantation is independently associated with poor patient and graft survival in male renal transplant recipients. J Urol 2014 192:1168-71.
• 5. Bhasin S, Cunningham GR, Hayes FJ, et al; Task Force, Endocrine Society. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2010 95:2536-59.
• 6. Katz S, Downs TD, Cash HR, et al. Progress in development of the index of ADL. Gerontologist 1970 10:20-30.
• 7. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018 103:1715-44.
• 8. Sterling J, Bernie AM, Ramasamy R. Hypogonadism: Easy to define, hard to diagnose, and controversial to treat. Can Urol Assoc J 2015 9:65-8.
• 9. Iglesias P, Carrero JJ, Diez JJ. Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options. J Nephrol 2012 25:31-42.
• 10. Shi Z, Araujo AB, Martin S, et al. Longitudinal changes in testosterone over five years in community-dwelling men. J Clin Endocrinol Metab 2013 98:3289-97 11. Cigarran S, Coronel F, Florit E, et al. Testosterone deficiency in dialysis patients: Difference between dialysis techniques. Nefrologia 2017 37:526-30.
• 12. Kim JH, Doo SW, Yang WJ, et al. Association between the hemodialysis adequacy and sexual dysfunction in chronic renal failure: a preliminary study. BMC Urol 2014 14:4.
• 13. Edey MM. Male Sexual Dysfunction and Chronic Kidney Disease. Frontiers in medicine 2017 4:32.
• 14. van Eps C, Hawley C, Jeffries J, et al. Changes in serum prolactin, sex hormones and thyroid function with alternate nightly nocturnal home haemodialysis. Nephrology(Carlton) 2012 17:42-7.
• 15. Ahlmen J, Carlsson L, Schonborg C. Well-informed patients with end-stage renal disease prefer peritoneal dialysis to hemodialysis. Perit Dial Int 1993 13:196-8.
• 16. Rubin HR, Fink NE, Plantinga LC, et al. Patient ratings of dialysis care with peritoneal dialysis vs hemodialysis. Jama 2004 291:697-703.
• 17. Heiman JR. Sexual dysfunction: overview of prevalence, etiological factors, and treatments. J Sex Res 2002 39:73-8.
• 18. Azevedo P, Santos R, Duraes J, et al. Sexual dysfunction in men and women on peritoneal dialysis: Differential link with metabolic factors and quality of life perception. Nefrologia 2014 34:703-9.
• 19. Chiang JM, Kaysen GA, Segal M, Chertow GM, Delgado C, johansen KL. Low testosterone is associated with frailty, muscle waisting and physical dysfunction, among men receiving hemodialysis: a longitudinal analysis. Nephrol Dial Transplant 2019 34(5):802-810
• 20. Khoo J, Tian HH, Tan B, et al. Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men. J Sex Med 2013 10:1823-32.
• 21. Russo GE, Morgia A, Cavallini M, et al. [Quality of life assessment in patients on hemodialysis and peritoneal dialysis]. G Ital Nefrol 2010 27:290-5.
• 22. Singh AB, Norris K, Modi N, et al. Pharmacokinetics of a Transdermal Testosterone System in Men with End Stage Renal Disease Receiving Maintenance Hemodialysis and Healthy Hypogonadal Men. J Clin Endocrinol Metab 2001 86:2437-45.