{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:08:16Z","timestamp":1789996096961,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) frequently coexists with hypothalamic\u2013pituitary\u2013gonadal dysfunction, yet the exposure\u2013response shape linking kidney function, testosterone, and outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on data from five cycles of the National Health and Nutrition Examination Survey (NHANES) and the UK Biobank (UKBB), we used multivariate logistic regression models and linear regression models to explore the associations between total testosterone levels and CKD as well as estimated glomerular filtration rate (eGFR). Subsequently, we plotted restricted cubic splines (RCS) of testosterone levels against the risk of CKD and the eGFR. Finally, we further verified the association between total testosterone levels and eGFR based on the kidney transplant cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across both populations, lower eGFR was revealed to be associated with lower total testosterone in an approximately linear fashion. RCS identified an inflection around the \u201cborderline low\u201d range of about 300\u2013400\u00a0ng\/dL; below that, CKD risk rose steeply, indicating a nonlinear, threshold\u2010like risk pattern. The logistic regression analysis based on the public databases also indicated that CKD would reduce testosterone levels (NHANES:\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u221217.98, 95% CI: \u221229.54, \u22126.420,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value = 3.4\u00a0\u00d7\u00a010\n                      <jats:sup>\u22123<\/jats:sup>\n                      ; UKBB:\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u221212.25, 95% CI: \u221214.84, \u22129.661,\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value = 1.9\u00a0\u00d7\u00a010\n                      <jats:sup>\u221220<\/jats:sup>\n                      ), but it had no effect on estradiol. In the validation cohort of kidney transplant recipients, total testosterone increased significantly after transplantation, whereas estradiol showed no parallel rise.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings demonstrate a clear linear\u2013threshold relationship between declining eGFR and reduced testosterone levels, and show that testosterone significantly increases after renal function recovery in kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70209","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:01:06Z","timestamp":1773234066000},"page":"2297-2308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower eGFR Associated With Decreased Total Testosterone in Males: Integrated Evidence From Cohorts to Real\u2010World Data"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0658-0945","authenticated-orcid":false,"given":"Yiding","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0213-3002","authenticated-orcid":false,"given":"Kun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5560-0917","authenticated-orcid":false,"given":"Feixiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiangsheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbiao","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4622-833X","authenticated-orcid":false,"given":"Jialin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of China"},{"name":"School of Life Sciences Anhui Medical University  Hefei People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-5515","authenticated-orcid":false,"given":"Guiyi","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of Anhui Medical University  Hefei People's Republic of China"},{"name":"Institute of Urology Anhui Medical University  Hefei People's Republic of China"},{"name":"Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation Anhui Medical University  Hefei People's Republic of 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