Hypogonadism may be associated with an increased risk of death in men with chronic kidney disease (CKD) not on dialysis, data suggest.

In a study of 2,419 men with CKD stages 3-4, those in the second lowest quintile of testosterone level (227-305 ng/dL) had a significant 53% increased risk of death compared with men in the highest quintile (512-3,153 ng/dL), in a fully adjusted model. Each 1 log unit increment in serum testosterone level was associated with a 30% decreased risk of death, after adjusting for confounders, including testosterone supplementation, researchers at Cleveland Clinic led by Daniel A. Shoskes, MD, reported online ahead of print in the American Journal of Kidney Diseases.

Of the 2,419 men, hypogonadism—defined as a serum testosterone level below 350 ng/dL—was found in 1,288 (53%). In multivariable analysis, African-American race was associated with a significant 35% decreased risk of hypogonadism compared with other races. Each 5 mL/min/1.73 m2 increment in estimated glomerular filtration rate was associated with a significant 8% decreased risk. Diabetes and increasing body mass index were associated with an increased likelihood of hypogonadism.

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A total of 357 subjects (14.8%) died during a median follow-up of 2.3 years.