Androgen deficiency and endothelial dysfunction in men with end-stage kidney disease receiving maintenance hemodialysis.
OBJECTIVE
Two thirds of men with end-stage kidney disease (ESKD) have serum testosterone levels in the hypogonadal range. We examined if low serum testosterone levels were correlated with measures of endothelial dysfunction in ESKD. Bilateral common carotid artery (CCA) intima-media thickness (IMT) and atherosclerotic plaque occurrence, left ventricular mass index, flow- (FMD) and nitrate-mediated vasodilatation (NMD) of the brachial artery were determined by ultrasound imaging in 100 nondiabetic men with ESKD (50 men exhibited androgen deficiency; serum testosterone concentrations <300 ng/dl).


RESULTS
Left-ventricular mass index, CCA diameter, CCA-IMT and atherosclerotic plaque occurrence were all significantly increased in ESKD patients with androgen deficiency compared with patients without androgen deficiency (p < 0.05). Also, FMD and NMD measurements were significantly reduced in the former compared with the latter (p < 0.05). Testosterone levels were inversely correlated with age and duration of hemodialysis therapy (r = -0.44 and r = -0.55; p < 0.001). Testosterone levels were negatively correlated to CCA-IMT and atherosclerotic plaque occurrence in patients with androgen deficiency (r = -0.32, p < 0.003, and r = -0.23, p < 0.04, respectively). FMD and NMD measurements were positively correlated to total (r = 0.65 and r = 0.61; both p < 0.0001) and free (r = 0.52 and r = 0.48; both p < 0.001) testosterone levels in patients with low androgenicity.


CONCLUSIONS
The present results indicated that ESKD patients with androgen deficiency had increased CCA-IMT, atherosclerotic plaque occurrence and reduced FMD and NMD compared with patients without androgen deficiency. Testosterone serum levels were negatively correlated to CCA-IMT and positively correlated to endothelium-dependent vasodilatation in ESKD patients with androgen deficiency.
Karakitsos
Dimitrios
D
Department of Nephrology, University Hospital of Heraklion, Crete, Greece.
Patrianakos
Alexandros P
AP
De Groot
Eric
E
Boletis
John
J
Karabinis
Andreas
A
Kyriazis
John
J
Samonis
George
G
Parthenakis
Frangiskos I
FI
Vardas
Panos E
PE
Daphnis
Eugene
E
D000328:Adult; D000728:Androgens / Q000172:deficiency*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013739:Testosterone / Q000097:blood*; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000473:pathology
D000728:Androgens; D013739:Testosterone