Testosterone is a hormone primarily associated with male characteristics, though also present in females. It influences various bodily functions, including muscle mass, bone density, and red blood cell production. Kidneys filter waste from the blood, regulate fluid and electrolyte balance, and produce hormones. This article explores how testosterone affects kidney health.
Testosterone’s Role in Kidney Health
Naturally occurring testosterone levels contribute to overall bodily function, supporting kidney health. This hormone regulates red blood cell production by stimulating the kidneys to produce erythropoietin. Additionally, testosterone supports nitric oxide production, which helps widen blood vessels and improve blood flow to organs, including the kidneys. Adequate blood flow is important for proper kidney function.
Within a healthy physiological range, testosterone may offer a protective influence on kidney function. Normal testosterone levels might have anti-inflammatory properties, shielding kidney cells from damage. Maintaining healthy testosterone levels can also improve metabolic health, including insulin sensitivity, which indirectly benefits kidney function by reducing strain. Conversely, low testosterone levels have been linked to an increased risk of chronic kidney disease and may accelerate its progression.
When Testosterone Levels Are Too High
When testosterone levels become abnormally high, they can negatively affect kidney health. This often occurs due to anabolic steroid misuse or poorly managed testosterone supplementation. One mechanism involves increased blood pressure, a leading cause of kidney damage. High testosterone can contribute to hypertension, increasing the kidneys’ workload.
Elevated testosterone levels can also lead to fluid retention, causing the body to hold more water and sodium. This increased fluid volume raises blood volume, straining the kidneys as they filter and excrete the excess. Another effect is increased red blood cell production, known as polycythemia. An excessive increase thickens the blood, making it harder for kidneys to filter and potentially slowing circulation, which can lead to fluid buildup.
High testosterone levels can also contribute to direct kidney cell damage. Such levels can induce changes like focal segmental glomerulosclerosis, a type of kidney scarring, and tubular atrophy. Evidence also suggests excessive testosterone may increase calcium levels in urine, potentially contributing to kidney stone formation. These effects can worsen existing kidney conditions, accelerating their decline.
Kidney Health During Testosterone Therapy
Testosterone replacement therapy (TRT), when administered under medical supervision to achieve physiological levels, is generally considered safe for kidney health. Medical oversight ensures testosterone levels remain within a normal range, mitigating risks from excessive levels.
Regular monitoring is important for protecting kidney function during TRT. Healthcare providers typically conduct blood tests to check testosterone levels, along with kidney function markers such as creatinine and estimated glomerular filtration rate (eGFR). They also monitor blood pressure and red blood cell count to detect adverse changes early. This comprehensive monitoring allows for timely treatment adjustments.
TRT treatment plans are individualized, with dosages tailored to each person’s health profile, especially with pre-existing kidney conditions. While TRT aims to restore testosterone to normal levels, improper dosing can still lead to elevated levels and potential risks. However, studies indicate that well-managed TRT can sometimes improve kidney function in hypogonadal men, showing reductions in urea and uric acid levels and increases in eGFR.