Parameters of spermiogenesis and their dynamics in patiens under 49 on haemodialysis waiting for kidney transplantation

Abstract

Aim: To evaluate the presence of abnormalities in serum hormone levels and semen analysis in patients under 49 years of age with chronic kidney disease (CKD) awaiting renal transplantation, and correlate the duration of haemodialysis and abnormalities with semen analysis. Methods: All male patients, age 18 to 49 with CKD on haemodialysis, awaiting kidney transplant, treated in cooperating haemodialysis centers, between September 2009 and April 2011, that met inclusion criteria, were included in the study.

The causes of CKD were identified, and duration of haemodialysis was recorded. The following tests were performed: semen analysis, serum levels of testosterone, SHBG, LH, FSH and prolactin.

The control group consisted of men between 18 and 49 years of age, who were investigated during the same period due to urolithiasis. Controls underwent the same testing as the study group.

Serum hormone levels and semen analysis parameters were compared between control and study groups. In addition, the same parameters were correlated with the duration of haemodialysis in the group of patients with CKD.

Parameters were expressed as mean ? standard deviation. Results: The study group consisted of 74 males, mean age 40 ? 7.5 and the control group consisted of 41 males, mean age 36.7 ? 8.8.

The average duration of CKD for the research participants was 130.4 ? 87.7 months and the average duration of haemodialysis was 48.8 ? 41.7 months. Average serum testosterone levels were lower in CKD patients then in the control group.

CKD patients were found to have significantly higher serum levels of SHBG, LH, FSH and prolactine, and significantly lower volume of ejaculate, total sperm count, sperm concentration, total and progressive sperm motility and sperm morphology. Within the group of patients a negative correlation between serum levels of testosterone and PRL, and a positive correlation between serum levels of LH and FSH as well as between serum levels of testosterone and total sperm motility and morphology was documented.

A negative correlation was detected between the duration of haemodialysis and testosterone levels, sperm concentration, total and progressive motility and sperm morphology. Conclusion: Significant changes in serum hormone levels and impaired semen analysis parameters were found in haemodialyzed patients waiting for kidney transplantation.

The severity of these changes was proportionate to the duration of haemodialysis. Early kidney transplantation could therefore prevent significant deterioration of fertility.