Testosterone therapy is associated with reduced risk of acute kidney injury, kidney failure with renal replacement therapy, and cardiovascular events in men with diabetes and hypogonadism
Authors' conclusion
In this large real-world cohort study, testosterone therapy in diabetic men with hypogonadism was associated with significant reductions in acute kidney injury, kidney failure requiring replacement therapy, major cardiovascular events, and total mortality. These findings suggest that testosterone therapy could be more readily considered for men with diabetes and hypogonadism as a potential intervention to prevent kidney injury.
Study context
- Population
- Men with diabetes and hypogonadism, TriNetX network; mean age 58 years (SD 12), 71% non-Hispanic Whitematched cohort
- Participants
- 26,027 vs 26,027
- Exposure
- Testosterone therapy vs no treatment
- Testosteronen = 26,027
- Untreatedn = 26,027reference
- Outcome
- Acute kidney injury and kidney failure requiring replacement therapy (dialysis or transplantation)
- Follow-up
- Mean 3.3 years
Methodological detailspropensity score matched 1:1, real-world, TriNetX Research Collaborative network
- Propensity score matched 1:1
- Real-world
- TriNetX Research Collaborative network
Main finding
As reported in the abstract
Acute kidney injury; kidney failure with replacement therapy
Testosterone vs UntreatedHazard ratio (95% CI)P value
Acute kidney injury
0.93(0.87–0.98)
P = 0.01Kidney failure with replacement therapy
0.81(0.72–0.92)
P = 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MI | 0.85 (0.78–0.93) | P < 0.0001 | |
| Ischemic stroke | 0.88 (0.80–0.97) | P = 0.01 | |
| AF | 0.91 (0.85–0.98) | P = 0.01 | |
| All-cause mortality | 0.85 (0.79–0.91) | P < 0.0001 | |
| 0.512Hazard ratio (log scale) |
Original publication
Testosterone therapy is associated with reduced risk of acute kidney injury, kidney failure with renal replacement therapy, and cardiovascular events in men with diabetes and hypogonadism. Cardiovasc Diabetol. Published 1 October 2025. doi:10.
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