Androgen Deficiency, Associations and Survival of Men With Stage 4 and 5 Chronic Kidney Disease: A Cohort Study
Authors' conclusion
AD is highly prevalent among this population, and increases further with older age and more severe CKD warranting haemodialysis. Association of lower Hb and higher ESA dose with lower T concentration might be causative, which has important pharmaco-economic as well as clinical implications. Lower survival in men with low T, more likely reflects overall poor health rather than causation. A properly constituted randomised controlled study evaluating the effect of native T replacement is warranted in men with CKD and AD.
Study context
- Population
- Males aged ≥18 years with chronic kidney disease (CKD) stages 4 and 5; mean age 63 years
- Participants
- 322 males
- Outcome
- Prevalence of androgen deficiency (AD)
Methodological detailsobservational, 15-year mortality follow-up for survival analysis
- Observational
- 15-year mortality follow-up for survival analysis
Main finding
As reported in the abstract
Overall prevalence of androgen deficiency (AD)
68.9%
Observational data: associations, not effects.
Further findings
Correlation between erythropoiesis stimulating agent (ESA) dose and testosterone concentrations
- Pearson correlation (negative, statistically significant), p = 0.05
- −0.193
Correlation between haemoglobin (Hb) and free testosterone in patients not on ESA therapy
- Pearson correlation (positive), p < 0.001
- 0.331
Survival by AD (Kaplan-Meier) · 15 years
- AD significantly associated with worse survival; log-rank p < 0.001
Free testosterone and survival (Cox regression) · 15 years
- Free testosterone not associated with survival; 95% CI
- 0.997-1.000
Original publication
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