Sexual hormone abnormalities in male patients with renal failure

Endocrine abnormalities are a common feature of chronic renal insufficiency w1,2x. Changes of androgen synthesis and metabolism develop early after the onset of renal insufficiency and are likely to be caused by primary hypogonadism anduor disturbances of the hypothalamic–pituitary axis. Uraemic toxins, co-morbidity, and concomitant drug administration are supposed to contribute to the observed changes, yet the exact mechanism remains unclear. Impaired function of the hypothalamic–pituitary–gonadal axis is not reversed by initiation of otherwise effective haemodialysis or peritoneal dialysis therapy. In contrast, renal transplantation was reported to restore endocrine function, but study results are conflicting. A complete normalization as well as persistingly low testosterone levels have been described after transplantation and gonadotrophin levels were also reported to be persistingly high or normal w3,4x. Pathophysiology and pathogenesis