Testosterone deficiency in patients with chronic kidney disease: prevalence and clinical significance (literature review)

Abstract

There is an increase in the prevalence of chronic kidney disease in the world. This is primarily due to the increase in the incidence of diabetes mellitus and arterial hypertension as the main etiological factors. A progressive decline in the excretory function of the kidneys is associated with metabolic disorders such as metabolic acidosis, hyperuricemia, hyperparathyroidism, oxidative and inflammatory stress, etc. This leads, in turn, to a decrease in the body weight of patients, primarily due to the loss of muscle mass. Such changes have an adverse effect, including on the synthesis of sex hormones, in particular, on the level of testosterone, the production of which decreases in the cohort of patients under discussion. Hormonal imbalance in the form of hypogonadism can play a significant role in increasing cardiovascular risk. Renal replacement therapy may be an independent risk factor for the development and progression of hypogonadism. At the same time, the problems of impaired regulation, synthesis and balance of sex hormones, as well as the issues of correction of secondary hypogonadism in patients with chronic kidney disease remain poorly understood and are of scientific interest.