The pituitary-testicular axis in men with chronic renal failure.
We studied the effects of uremia on the pituitary-testicular axis in 35 men with creatinine clearances less than 4 ml per minute per 1.7m(2). We found significant elevation (p less than 0.001) of plasma luteinizing hormone and follicle-stimulating hormone (p less than 0.005) and subnormal levels of testosterone (p less than 0.005). Testicular histology revealed severe spermatogenic damage. Human chorionic gonadotropin produced a subnormal testosterone response. The initial response of plasma luteinizing hormone and follicle-stimulating hormone to luteinizing-hormone-releasing hormone was normal, but their subsequent decline was prolonged. The suppression of plasma luteinizing hormone levels by testosterone propionate was normal, but the nadir occurred late; the elevated plasma luteinizing hormone level was due to reduced metabolic clearnace and increased production. Chronic renal failure interferes with testicular steroid production and spermatogenesis.
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D006063:Chorionic Gonadotropin / Q000494:pharmacology; D005246:Feedback; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D007989:Libido; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000503:physiopathology*; D006435:Renal Dialysis; D012636:Secretory Rate / Q000187:drug effects; D013091:Spermatogenesis; D013737:Testis / Q000503:physiopathology*; D013739:Testosterone / Q000378:metabolism; D014511:Uremia / Q000628:therapy
D006063:Chorionic Gonadotropin; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone