Salivary testosterone for the diagnosis of androgen deficiency in end-stage renal disease.
BACKGROUND
Hypogonadism is frequent in patients with end-stage renal disease (ESRD). Salivary testosterone (Sal-T) is a non-invasive tool to screen androgen deficiency in adult male with normal renal function. However, available data on its utility in ESRD are not conclusive.


OBJECTIVE
The objectives of the study were: (i) to compare free testosterone fractions in saliva (SAL-T) and serum (Free-T); (ii) to establish the correlation of Sal-T with circulating total (TT) and bioavailable testosterone (Bio-T); (iii) to detect androgen deficiency through Sal-T; (iv) to determine the correlation of Sal-T with clinical parameters.


METHODS
The study included: 60 adult ESRD men on haemodialysis (20-60 years old) with decreased libido referred from two dialysis centres; 112 eugonadic and 40 hypogonadic adult men with normal renal function as controls. Simultaneous morning saliva and serum samples were obtained for testosterone measurements by liquid RIA (SAL-T; TT). Free-T and Bio-T were calculated by the Vermeulen equation.


RESULTS
Sal-T (0.338±0.177 nM) and Free-T (0.338±0.165 nM) did not differ (P>0.900) in ESRD as well as in control (0.337±0.182 and 0.337±0.172 nM, respectively; P>0.900). Sal-T levels correlated positively (P<0.0001) with Free-T (r=0.95), TT (r=0.80) and Bio-T (r=0.76) in ESRD. Sal-T negatively correlated with age and years on dialytic therapy. Sal-T showed 100% sensitivity and specificity to differentiate patients with androgen deficiency (22%) from those with normal androgen levels (78%). Hypogonadism was hypergonadotrophic in 69% cases and hypogonadotrophic in 31%.


CONCLUSIONS
These data demonstrate the value of morning Sal-T testing as a non-invasive approach to screen androgen status in ESRD patients.
Cardoso
Estela M L
EM
Endocrine Research Department, Instituto de Investigaciones Médicas A. Lanari, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina. endoexp2000@yahoo.com
Contreras
Liliana N
LN
Tumilasci
Elida G
EG
Elbert
Alicia
A
Aguirre
Elvira C
EC
Aquilano
Daniel R
DR
Arregger
Alejandro L
AL
D000328:Adult; D000728:Androgens / Q000172:deficiency*; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry*; D013739:Testosterone / Q000032:analysis* / Q000097:blood; D055815:Young Adult
D000728:Androgens; D013739:Testosterone