The impact of long-term Testosterone Therapy (TTh) in renal function (RF) among hypogonadal men: An observational cohort study

Mustafa Alwani; Raed M Al-Zoubi; Ahmad Al-Qudimat; Aksam Yassin; Omar Aboumarzouk; Khaled Al-Rumaihi; Raidh Talib; Abdulla Al-Ansari

doi:10.1016/j.amsu.2021.102748

The impact of long-term Testosterone Therapy (TTh) in renal function (RF) among hypogonadal men: An observational cohort study

Ann Med Surg (Lond). 2021 Aug 23:69:102748. doi: 10.1016/j.amsu.2021.102748. eCollection 2021 Sep.

Authors

Mustafa Alwani^{1

2}, Raed M Al-Zoubi^{1

3}, Ahmad Al-Qudimat¹, Aksam Yassin^{1

4

5}, Omar Aboumarzouk¹, Khaled Al-Rumaihi⁴, Raidh Talib⁴, Abdulla Al-Ansari¹

Affiliations

¹ Surgical Research Section, Department of Surgery Hamad Medical Corporation, Doha, Qatar.
² School of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
³ Department of Chemistry, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan.
⁴ Department of Surgery, Division of Urology/Andrology, Hamad Medical Corporation, Doha, Qatar.
⁵ Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany.

Abstract

Objectives: Testosterone therapy (TTh) is the main treatment for elderly men with hypogonadism. No evidence of the long-term effectiveness of TTh on renal function is reported to date.

Methods: In this study, we evaluated the long-term TTh of testosterone undecanoate (TU) administration on renal function parameters in 496 symptomatic hypogonadal men, with T levels ≤350 ng/dL. The treatment group (T-group) consisted of 312 patients and obtained TU 1000 mg for 12 weeks followed by 6-week intervals and for up to 8 years. The remaining 184 hypogonadal men, who opted against TTh, served as a control group (C-group). The two groups were similar in criteria prior to treatment. We evaluated renal function by calculating serum creatinine, urea, uric acid, and glomerular filtration rate (GFR) according to Mayo Clinic guidelines for 8 years. This study obeys the ethical guidelines of German medical association according to Section 15 of the Professional Code, document for AY- Ref. EK/CH/AU signed on Jun 2015.

Results: During the study period, the T-group exhibited lower levels of urea (47.0 ± 11.8 to 34.0 ± 13.9 mg/dL), uric acid (6.57 ± 1.2 to 5.49 ± 1.5 mg/dL), serum creatinine (0.90 ± 0.10 to 1.12 ± 0.9 mg/dL), and higher-level in GFR (87.0 ± 12.9 to 98.0 ± 8.0 mL/min/1.73 m²), which were significant. Alternatively, the C-group exhibited an increase in their serum creatinine (1.16 ± 0.31 to 1.19 ± 0.58 mg/dL), an increase in uric acid (5.54 ± 1.2 to 5.44 ± 1.7 mg/dL), and a decrease in GFR (92.0 ± 20.1 to 87.0 ± 26.1 mL/min/1.73 m²). A total of 25 deaths (7.8%) was recorded in the T-group, among them 11 (44%) were cardiovascular. On the other hand, 28 patients (15.2%) died in C-group and all deaths (100%) were found to cardiovascular causes.

Conclusion: The results suggest that long-term TTh could improve renal function in hypogonadal men comparing to slight deterioration observed in patients without intervention. In addition to reduce mortality in cardiovascular patients, almost to the half.

Keywords: Hypogonadism; Men; Renal Function; Testosterone Therapy.