{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T23:45:46Z","timestamp":1782776746147,"version":"3.54.5"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Male hypogonadism is highly prevalent among patients undergoing dialysis and carries significant clinical implications, although is often overlooked. Testosterone deficiency in this population is associated with adverse clinical outcomes, mainly because of cardiovascular disease, protein energy wasting and infection complication. Therefore, identify these patients is a high clinical priority.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross-sectional study that enrolled adult men on maintenance hemodiafiltration in four dialysis centers. Hypogonadism was defined by two consecutive measurements of serum total testosterone levels. Free testosterone was calculated based on serum albumin and sex hormone-binding globulin. Symptoms of androgen deficiency were evaluated using androgen deficiency in aging males (ADAM) questionnaire. The presence of comorbidities and laboratory markers was also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hypogonadism was identified in 59 out of 121 patients (48.7%). Patients with hypogonadism were older (62 \u00b1 15 vs. 57 \u00b1 15 years,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and had higher prolactin levels (22 [13\u201336] vs. 14 [10\u201318] ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). No other significant difference was observed in demographic, clinical, or laboratory features between patients with and without hypogonadism. Among the 16 patients who received testosterone supplementation, 66.7% showed improvement in ADAM scores, with the median score decreasing from 3 (2\u20134) to 1 (0\u20132) (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>More than one-third of men undergoing hemodiafiltration were diagnosed with hypogonadism. Aside from older age, no other distinguishing characteristics were identified in this population. Therefore, routine assessment of testosterone levels should be considered for all men undergoing dialysis. Further studies are needed to determine whether hormone supplementation can improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1744953","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:22:17Z","timestamp":1769577737000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Male hypogonadism in patients on maintenance hemodiafiltration: prevalence and therapeutic effect"],"prefix":"10.3389","volume":"17","author":[{"given":"Marcia S.","family":"Carvalho","sequence":"first","affiliation":[{"name":"Nefrostar Kidney Care","place":["Sao Paulo, Brazil"]},{"name":"Splendore Kidney Care","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raissa C.","family":"Torres","sequence":"additional","affiliation":[{"name":"Faculdade S\u00e3o Leopoldo Mandic Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela M.","family":"Toniasso","sequence":"additional","affiliation":[{"name":"Faculdade S\u00e3o Leopoldo Mandic Campinas","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea O.","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Nefrostar Kidney Care","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M.","family":"Borges","sequence":"additional","affiliation":[{"name":"Splendore Kidney Care","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica P.","family":"Rocha","sequence":"additional","affiliation":[{"name":"Nefrostar Kidney Care","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane A.","family":"Kojima","sequence":"additional","affiliation":[{"name":"Nefrostar Kidney Care","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosilene M.","family":"Elias","sequence":"additional","affiliation":[{"name":"Nefrostar Kidney Care","place":["Sao Paulo, Brazil"]},{"name":"Splendore Kidney Care","place":["Sao Paulo, Brazil"]},{"name":"Department of Medicine, Service of Nephrology, University of Sao Paulo","place":["Sao Paulo, Brazil"]},{"name":"Universidade Nove de Julho","place":["Sao Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2006.045963","article-title":"Prevalence of hypogonadism in male patients with renal failure","volume":"82","author":"Albaaj","year":"2006","journal-title":"Postgrad Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"31","DOI":"10.5301\/JN.2011.8481","article-title":"Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options","volume":"25","author":"Iglesias","year":"2012","journal-title":"J Nephrol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2017.03.014","article-title":"Testosterone deficiency in dialysis patients: Difference between dialysis techniques","volume":"37","author":"Cigarran","year":"2017","journal-title":"Nefrologia"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/nu14163438","article-title":"Testosterone deficiency as one of the major endocrine disorders in chronic kidney disease","volume":"14","author":"Romejko","year":"2022","journal-title":"Nutrients"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.5.1036","article-title":"Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men","volume":"27","author":"Laaksonen","year":"2004","journal-title":"Diabetes Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.04.016","article-title":"The effects of testosterone on risk factors for, and the mediators of, the atherosclerotic process","volume":"207","author":"Jones","year":"2009","journal-title":"Atherosclerosis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1530\/eje.1.02166","article-title":"Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes","volume":"154","author":"Kapoor","year":"2006","journal-title":"Eur J Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12719","article-title":"Late-onset hypogonadism: a concept comes of age","volume":"8","author":"Nieschlag","year":"2020","journal-title":"Andrology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e20240065","DOI":"10.1590\/2175-8239-JBN-2024-0065en","article-title":"Erectile dysfunction among men with chronic kidney disease undergoing hemodialysis in a Brazilian Amazon urban setting: an epidemiological study","volume":"46","author":"Barros Neto","year":"2024","journal-title":"J Bras Nefrol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012080875","article-title":"High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients","volume":"24","author":"Maduell","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2024.07.014","article-title":"The CONVINCE randomized trial found positive effects on quality of life for patients with chronic kidney disease treated with hemodiafiltration","volume":"106","author":"Rose","year":"2024","journal-title":"Kidney Int"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14113981","article-title":"BRIGHT-HD-A Brazilian research investigation on public health gains comparing survival rates between hemodialysis and hemodiafiltration: an observational study","volume":"14","author":"Luciano","year":"2025","journal-title":"J Clin Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1053\/j.ajkd.2025.04.013","article-title":"Mortality on hemodiafiltration compared to high-flux hemodialysis: A Brazilian cohort study","volume":"86","author":"Strogoff-de-Matos","year":"2025","journal-title":"Am J Kidney Dis"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13020594","article-title":"Comparing survival outcomes between hemodialysis and hemodiafiltration using real-world data from Brazil","volume":"13","author":"da Rocha","year":"2024","journal-title":"J Clin Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1080\/13685538.2021.1962840","article-title":"Recommendations on the diagnosis, treatment and monitoring of testosterone deficiency in men","volume":"24","author":"Lunenfeld","year":"2021","journal-title":"Aging Male"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2020.760","article-title":"Current national and international guidelines for the management of male hypogonadism: helping clinicians to navigate variation in diagnostic criteria and treatment recommendations","volume":"35","author":"Al-Sharefi","year":"2020","journal-title":"Endocrinol Metab (Seoul)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12770","article-title":"European Academy of Andrology (EAA) guidelines on investigation, treatment and monitoring of functional hypogonadism in males: Endorsing organization: European Society of Endocrinology","volume":"8","author":"Corona","year":"2020","journal-title":"Andrology"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/ijir.2009.35","article-title":"The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism","volume":"22","author":"Mohamed","year":"2010","journal-title":"Int J Impot Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-00229","article-title":"Testosterone therapy in men with hypogonadism: an endocrine society clinical practice guideline","volume":"103","author":"Bhasin","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14574","article-title":"Arterial and venous thrombosis by high platelet count and high hematocrit: 108\u2013521 individuals from the Copenhagen General Population Study","volume":"17","author":"Warny","year":"2019","journal-title":"J Thromb Haemost"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.22124","article-title":"Association of hematocrit with blood pressure and hypertension","volume":"31","author":"Emamian","year":"2017","journal-title":"J Clin Lab Anal"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2019-001233","article-title":"Male hypogonadism: a review","volume":"68","author":"Marcelli","year":"2020","journal-title":"J Investig Med"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2016.01.010","article-title":"Treatment of the testosterone deficiency in hemodialysis patients","volume":"36","author":"Pampa Saico","year":"2016","journal-title":"Prelim Results Nefrol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2015.11.003","article-title":"EMAS position statement: Testosterone replacement therapy in the aging male","volume":"84","author":"Dimopoulou","year":"2016","journal-title":"Maturitas"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(03)00242-9","article-title":"The aging male: testosterone deficiency and testosterone replacement. An up-date","volume":"173","author":"Alexandersen","year":"2004","journal-title":"Atherosclerosis"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.2.8201","article-title":"Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study","volume":"87","author":"Feldman","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X710729","article-title":"How to manage low testosterone level in men: a guide for primary care","volume":"70","author":"Al-Sharefi","year":"2020","journal-title":"Br J Gen Pract"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.2.7219","article-title":"Baltimore Longitudinal Study of A. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging","volume":"86","author":"Harman","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1177\/1557988318772734","article-title":"Efficacy of testosterone treatment in hemodialysis patients as assessed by aging males\u2019 Symptoms scores: A pilot study","volume":"12","author":"Inoue","year":"2018","journal-title":"Am J Mens Health"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.230110","article-title":"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","volume":"42","author":"Pan","year":"2024","journal-title":"World J Mens Health"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1373\/jalm.2016.022012","article-title":"Hematopoiesis shows closer correlation with calculated free testosterone in men than total testosterone","volume":"1","author":"Woods","year":"2017","journal-title":"J Appl Lab Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.06.010","article-title":"Serum testosterone levels and clinical outcomes in male hemodialysis patients","volume":"63","author":"Bello","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041395","article-title":"Effect of transdermal testosterone and oral progesterone on drug-induced QT interval lengthening in older men: A randomized, double-blind, placebo-controlled crossover-design study","volume":"140","author":"Muensterman","year":"2019","journal-title":"Circulation"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1159\/000485998","article-title":"The metabolic syndrome in central hypogonadotrophic hypogonadism","volume":"49","author":"Dwyer","year":"2018","journal-title":"Front Horm Res"},{"key":"B35","volume-title":"Endocrine Society Position Statement on Male Hypogonadism and Aging","year":"2018"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.6895","article-title":"Trends in androgen prescribing in the United States, 2001 to 2011","volume":"173","author":"Baillargeon","year":"2013","journal-title":"JAMA Intern Med"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-3570","article-title":"Testosterone lab testing and initiation in the United Kingdom and the United States, 2000 to 2011","volume":"99","author":"Layton","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2019.03.262","article-title":"Testosterone deficiency: A review and comparison of current guidelines","volume":"16","author":"Kwong","year":"2019","journal-title":"J Sex Med"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911101","article-title":"Identification of late-onset hypogonadism in middle-aged and elderly men","volume":"363","author":"Wu","year":"2010","journal-title":"N Engl J Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1744953\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:22:18Z","timestamp":1769577738000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1744953\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":39,"alternative-id":["10.3389\/fendo.2026.1744953"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1744953","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"article-number":"1744953"}}