BACKGROUND AND OBJECTIVES: Low serum testosterone levels in hemodialysis (HD) patients have recently been associated with cardiovascular risk factors and increased mortality. To confirm this observation, we investigated the predictive role of serum total testosterone levels on mortality in a large group of male HD patients from Turkey. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: A total of 420 prevalent male HD patients were sampled in March 2005 and followed up for all-cause mortality. Serum total testosterone levels were measured by ELISA at baseline and studied in relation to mortality and cardiovascular risk profile. RESULTS: Mean testosterone level was 8.69 ± 4.10 (0.17 to 27.40) nmol/L. A large proportion of patients (66%) had testosterone deficiency (<10 nmol/L). In univariate analysis, serum testosterone levels were positively correlated with creatinine and inversely correlated with age, body mass index, and lipid parameters. During an average follow-up of 32 months, 104 (24.8%) patients died. The overall survival rate was significantly lower in patients within the low testosterone tertile (<6.8 nmol/L) compared with those within the high tertile (>10.1 nmol/L; 64 versus 81%; P = 0.004). A 1-nmol/L increase in serum testosterone level was associated with a 7% decrease in overall mortality (hazard ratio 0.93; 95% confidence interval 0.89 to 0.98; P = 0.01); however, this association was dependent on age and other risk factors in adjusted Cox regression analyses. CONCLUSIONS: Testosterone deficiency is common in male HD patients. Although testosterone levels, per se, predicted mortality in this population, this association was largely dependent on age.
BACKGROUND AND OBJECTIVES: Low serum testosterone levels in hemodialysis (HD) patients have recently been associated with cardiovascular risk factors and increased mortality. To confirm this observation, we investigated the predictive role of serum total testosterone levels on mortality in a large group of male HDpatients from Turkey. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: A total of 420 prevalent male HDpatients were sampled in March 2005 and followed up for all-cause mortality. Serum total testosterone levels were measured by ELISA at baseline and studied in relation to mortality and cardiovascular risk profile. RESULTS: Mean testosterone level was 8.69 ± 4.10 (0.17 to 27.40) nmol/L. A large proportion of patients (66%) had testosterone deficiency (<10 nmol/L). In univariate analysis, serum testosterone levels were positively correlated with creatinine and inversely correlated with age, body mass index, and lipid parameters. During an average follow-up of 32 months, 104 (24.8%) patients died. The overall survival rate was significantly lower in patients within the low testosterone tertile (<6.8 nmol/L) compared with those within the high tertile (>10.1 nmol/L; 64 versus 81%; P = 0.004). A 1-nmol/L increase in serum testosterone level was associated with a 7% decrease in overall mortality (hazard ratio 0.93; 95% confidence interval 0.89 to 0.98; P = 0.01); however, this association was dependent on age and other risk factors in adjusted Cox regression analyses. CONCLUSIONS:Testosterone deficiency is common in male HDpatients. Although testosterone levels, per se, predicted mortality in this population, this association was largely dependent on age.
Authors: Varant Kupelian; Stephanie T Page; Andre B Araujo; Thomas G Travison; William J Bremner; John B McKinlay Journal: J Clin Endocrinol Metab Date: 2006-01-04 Impact factor: 5.958
Authors: Kay-Tee Khaw; Mitch Dowsett; Elizabeth Folkerd; Sheila Bingham; Nicholas Wareham; Robert Luben; Ailsa Welch; Nicholas Day Journal: Circulation Date: 2007-11-26 Impact factor: 29.690
Authors: Molly M Shores; Victoria M Moceri; David A Gruenewald; Kayla I Brodkin; Alvin M Matsumoto; Daniel R Kivlahan Journal: J Am Geriatr Soc Date: 2004-12 Impact factor: 5.562
Authors: Andre B Araujo; Gretchen R Esche; Varant Kupelian; Amy B O'Donnell; Thomas G Travison; Rachel E Williams; Richard V Clark; John B McKinlay Journal: J Clin Endocrinol Metab Date: 2007-08-14 Impact factor: 5.958
Authors: Juan Jesús Carrero; John Kyriazis; Alper Sonmez; Ioannis Tzanakis; Abdul Rashid Qureshi; Peter Stenvinkel; Mutlu Saglam; Kostas Stylianou; Halil Yaman; Abdullah Taslipinar; Abdulgaffar Vural; Mahmut Gok; Mujdat Yenicesu; Eugene Daphnis; Mahmut Ilker Yilmaz Journal: Clin J Am Soc Nephrol Date: 2011-12-22 Impact factor: 8.237
Authors: Jasna Aleksova; Alexander J Rodriguez; Robert McLachlan; Peter Kerr; Frances Milat; Peter R Ebeling Journal: Curr Osteoporos Rep Date: 2018-12 Impact factor: 5.096
Authors: Jerry Yu; Vanessa A Ravel; Amy S You; Elani Streja; Matthew B Rivara; Praveen K Potukuchi; Steven M Brunelli; Csaba P Kovesdy; Kamyar Kalantar-Zadeh; Connie M Rhee Journal: Am J Nephrol Date: 2017-09-01 Impact factor: 3.754
Authors: Alice Bonanni; Irene Mannucci; Daniela Verzola; Antonella Sofia; Stefano Saffioti; Ezio Gianetta; Giacomo Garibotto Journal: Int J Environ Res Public Health Date: 2011-05-19 Impact factor: 3.390
Authors: Stanislaw Niemczyk; Longin Niemczyk; Katarzyna Szamotulska; Zbigniew Bartoszewicz; Katarzyna Romejko-Ciepielewska; Malgorzata Gomółka; Marek Saracyn; Joanna Matuszkiewicz-Rowińska Journal: Med Sci Monit Date: 2015-11-07