Clinical and Experimental Nephrology

, Volume 18, Issue 3, pp 499–506 | Cite as

Low serum testosterone is associated with atherosclerosis in postmenopausal women undergoing hemodialysis

  • Nobuaki Shiraki
  • Ayumu NakashimaEmail author
  • Shigehiro Doi
  • Juan Jesús Carrero
  • Naoko Sugiya
  • Toshinori Ueno
  • Peter Stenvinkel
  • Nobuoki Kohno
  • Takao Masaki
Original Article



Low serum testosterone levels have been recently linked to endothelial dysfunction, arterial stiffness, and worse outcomes in male hemodialysis patients. We tested the hypothesis that low serum testosterone levels are also associated with atherosclerosis risk factors in postmenopausal women undergoing hemodialysis.


We measured serum testosterone in 115 confirmed postmenopausal ethnically Japanese women undergoing hemodialysis with mean age of 68.1 ± 10.6 years and median dialysis vintage of 73 months. The severity of atherosclerosis was evaluated by carotid intima–media thickness (cIMT) and cardio–ankle vascular index (CAVI). In addition, we also included a control cohort of 32 age-matched postmenopausal women without chronic kidney disease.


Serum testosterone was significantly lower in women undergoing hemodialysis than in age-matched controls. Women undergoing hemodialysis who had undetectable testosterone concentration presented higher cIMT and higher CAVI than women undergoing hemodialysis with testosterone concentration above detection limits (P < 0.05 for all). Multiple logistic regression analyses confirmed the independence of these associations.


Serum testosterone levels in postmenopausal women undergoing hemodialysis are abnormally low and associated with features of atherosclerosis.


Testosterone Atherosclerosis Hemodialysis Postmenopausal woman 



This study was supported by Grants-in-Aid for kidney failure and hemodialysis research from the Japanese Association of Dialysis Physicians. J.J.C. acknowledges the support of the Swedish Research Council, the Kvinnor och Hälsa and the Loo and Hans Osterman Foundations.

Conflict of interest

J.J.C. and P.S. are investigators of an intervention study to test the effects of testosterone undecanoate in male hypogonadal HD patients with partial support from Bayer Pharmaceuticals. No other author declares a personal or financial conflict of interest.


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Copyright information

© Japanese Society of Nephrology 2013

Authors and Affiliations

  • Nobuaki Shiraki
    • 1
  • Ayumu Nakashima
    • 1
    • 2
    Email author
  • Shigehiro Doi
    • 1
  • Juan Jesús Carrero
    • 4
    • 5
  • Naoko Sugiya
    • 6
  • Toshinori Ueno
    • 1
  • Peter Stenvinkel
    • 4
  • Nobuoki Kohno
    • 3
  • Takao Masaki
    • 1
  1. 1.Department of NephrologyHiroshima University HospitalHiroshimaJapan
  2. 2.Department of Regenerative MedicineHiroshima University HospitalHiroshimaJapan
  3. 3.Department of Molecular and Internal Medicine, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
  4. 4.Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden
  5. 5.Centre for Molecular MedicineKarolinska InstitutetStockholmSweden
  6. 6.Department of NephrologyKure Kyosai HospitalKureJapan

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