title: Is Free Testosterone Concentration a Prognostic Factor of Survival in Chronic Renal Failure (CRF)?
abstract: BACKGROUND
  Lowered testosterone level in CRF patients is associated with elevated risk of death due to cardiovascular reasons, and is influenced by many factors, including acid-base balance disorders.
  
  
  OBJECTIVE
  evaluation of testoste-rone concentration (TT) and free testosterone concentration (fT) in pre-dialysis and dialysis patients; assessment of TT and fT relationships with biochemical parameters; evaluation of prognostic importance of TT and fT in predicting patient survival.
  
  
  METHODS
  4 groups of men: 14 - on hemodialysis (HD), 13 - on peritoneal dialysis (PD), 9 - with chronic renal failure (CRF) and 8 - healthy (CG), aged 56±17, 53±15, 68±12, 43±10 years, respectively. TT and biochemical para-meters were measured; fT was calculated.
  
  
  RESULTS
  The lowest TT and fT were observed in HD and CRF, the highest - in CG (p=0.035 for TT; p=0.007 for fT). fT in CRF and CG were different (p=0.031). TT and age was associated in HD (p=0.026). Age and fT was strongly associated in PD (p<0.001). After adjustment for age, TT was negatively associated with BMI (p=0.013) and fT was positively associated with HCO3 level (p=0.007). fT was lower in those who died during 5 years of observation than in survivors (p=0.009). We have found that, opposite to TT, fT appeared to be a better predictor of 5-year survival than age. After combining pH and HCO3 levels into a single variable - no acidosis, acidosis with HCO3 normal serum level, acidosis with low concentrations of HCO3 and adjustment for age and the study group - a trend toward the lowest values of free testosterone in decompensated acidosis was observed (ptrend=0.027). Such a trend was not seen for testosterone concentrations (ptrend=0.107).
  
  
  CONCLUSIONS
  Total and free testosterone levels were lower in HD and pre-dialysis than in healthy patients. Free testost-erone level may predict long-term survival better than age. Total and free testosterone levels are lower in metabolic acidosis and total and free testosterone levels were positively associated with HCO3 level.
authors.affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Niemczyk
authors.affiliation: Department of Nephrology, Dialysotherapy and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Longin
authors.initials: L
authors.lastname: Niemczyk
authors.affiliation: Department of Epidemiology and Biostatistics, National Research Institute of Mother and Child, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szamotulska
authors.affiliation: Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Bartoszewicz
authors.affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Romejko-Ciepielewska
authors.affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Gomółka
authors.affiliation: Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Saracyn
authors.affiliation: Department of Nephrology, Dialysotherapy and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Matuszkiewicz-Rowińska
mesh_terms: D000138:Acidosis; D000368:Aged; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012044:Regression Analysis; D016019:Survival Analysis; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D013739:Testosterone