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Kidney Week

Abstract: FR-PO0419

Male Hypogonadism in Patients on Maintenance Hemodialysis: The Diagnosis with No Clear Clue

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Carvalho, Marcia S, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Torres, Raissa, Faculdade Sao Leopoldo Mandic, Campinas, SP, Brazil
  • Toniasso, Isabela, Faculdade Sao Leopoldo Mandic, Campinas, SP, Brazil
  • Magalhães, Andréa Olivares, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Borges, Cynthia Moura, Splendore Kidney Care, Sao Paulo, Brazil
  • Rocha, Érica Pires da, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Kojima, Christiane, Nefrostar Kidney Care, Sao Paulo, Brazil
  • Elias, Rosilene M., Nefrostar Kidney Care, Sao Paulo, Brazil
Background

Male hypogonadism is highly prevalent among patients undergoing dialysis and carries significant clinical implications. Testosterone deficiency in this population is associated with increased frailty, muscle wasting, sarcopenia, and physical dysfunction—all of which are critical concerns. Despite its frequency, the diagnosis of hypogonadism is often overlooked. Our objective was to assess the presence of male hypogonadism in patients receiving hemodiafiltration and to investigate its relationship with clinical and demographic characteristics.

Methods

This cross-sectional observational study examines male hypogonadism in patients undergoing maintenance dialysis. Adult men from three dialysis centers in Brazil were included. The primary outcome was the presence of hypogonadism, determined by two consecutive measurements of serum total testosterone levels. Free testosterone was calculated based on serum albumin and sex hormone-binding globulin (SHBG). Symptoms of androgen deficiency was tested using questionnaire for androgen deficiency in aging males (ADAM). The presence of comorbidities and relevant laboratory markers was also evaluated.

Results

Hypogonadism was identified in 61 out of 175 patients (34.8%). Patients with hypogonadism were older (61.5 ± 15.5 vs. 56.8 ± 15.0 years, p = 0.002) and had higher prolactin levels (21 [14–35] vs. 15 [10–26] ng/mL, p = 0.023). No other significant differences were observed in demographic, clinical, or laboratory characteristics between patients with and without hypogonadism. Among the 16 patients who received testosterone supplementation, 66.7% showed improvement in ADAM scores, with the median score decreasing from 3 (2–4) to 1 (0–2) (p = 0.003).

Conclusion

More than one-third of patients on dialysis were diagnosed with hypogonadism. Apart from being older, no other distinguishing features were identified in this population. Therefore, routine testosterone assessment should be considered for all patients undergoing dialysis. Whether hormone supplementation will improve clinical outcomes needs further evaluation.

Digital Object Identifier (DOI)