Is There a Two-Way Risk between Decreased Testosterone Levels and the Progression and Prognosis of Chronic Kidney Disease? A Cohort Study Based on the National Health and Nutrition Examination Survey Database

• Published in: The world journal of men's health pp. 429 - 440
• Main Authors: Jiashan Pan(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University), Zhenming Zheng(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Xike Mao(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Dekai Hu(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Wenbo Wang(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Guiyi Liao(Department of Urology, The First Affiliated Hospital of Anhui Medical University, Zongyao Hao(Department of Urology, The First Affiliated Hospital of Anhui Medical University
• Format: Journal Article
• Language: English
• Published: 대한남성과학회 01.04.2024
• Subjects: 비뇨기과학
• ISSN: 2287-4208; 2287-4690
• DOI: 10.5534/wjmh.230110

Purpose: The causal relationship between the incidence and prognosis of chronic kidney disease (CKD) and serum testosterone levels in patients is not yet fully understood. This study aims to use the National Health and Nutrition Examination Survey (NHANES), a large-scale nationally representative sample, to investigate the relationship between CKD and testosterone. Materials and Methods: This study included six NHANES cycles for linear regression analysis, verified by multiple imputation methods. Stratified analysis and subgroup analysis were used to demonstrate the stability of CKD’s effect on testosterone. Furthermore, we used Kaplan-Meier plots and log-rank tests to evaluate differences in survival rates between CKD male patients with low and normal levels of testosterone. Results: From a total of 71,163 subjects, the cohort selected 28,663 eligible participants. Results showed that CKD patients had testosterone levels 28.423 ng/mL (24.762, 32.083) lower than non-CKD patients. The results of multiple imputations (β=27.700, 95% confidence interval: 23.427, 31.974) were consistent with those of linear regression analysis, and the numerical match was good. Stratified regression analysis, and subgroup analysis results showed that CKD had a significant impact on testosterone at different dimensions. Kaplan-Meier plots showed significantly reduced survival rates in low testosterone CKD male patients (p<0.0001). Conclusions: The results of this big data analysis suggest that there may be a two-way risk between low levels of testosterone and CKD. The testosterone levels of CKD patients were significantly lower than those of the non-CKD population, and CKD patients with low testosterone levels had poorer prognoses. These results suggest that correcting testosterone levels in a timely manner can have preventive and therapeutic effects on the progression of CKD. KCI Citation Count: 1