Keywords
Chronic Kidney Disease
Hypogonadotropic Hypogonadism
Cardiovascular Safety
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Abstract
Objective: To investigate the safety and efficacy of testosterone replacement therapy (TRT) in men with chronic kidney disease (CKD) and hypogonadotropic hypogonadism, focusing on clinical outcomes and cardiovascular safety. Literature Review: Testosterone Replacement Therapy (TRT) in men with Chronic Kidney Disease (CKD) and hypogonadism aims to restore hormone levels, improving several functions, such as libido, muscle mass, bone density and mood; It can be administered by several routes that vary, with intramuscular administration being associated with greater cardiovascular risk due to hepatic metabolism. The cardiovascular safety of TRT is controversial; initial studies suggested risks, but recent research has not confirmed an increase in major cardiovascular events, although they have excluded patients with advanced CKD. Patients with CKD have multiple comorbidities, such as atherosclerosis, vascular calcification and chronic inflammation, which require individualized assessment of the risks and benefits of TRT, as well as rigorous monitoring. Final considerations: TRT is considered a promising treatment and can significantly improve quality of life. However, high-quality studies, specifically focused on the CKD population, with standardized protocols and longer follow-up, are essential to assess long-term safety and efficacy, including subgroup analyses, cardiovascular risk biomarkers and different stages of CKD.
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