losartan-potassium and testosterone-enanthate

Testosterone formulations that have more steady-state pharmacokinetics, such as subcutaneously implanted testosterone pellets, may cause less erythrocytosis than i.m. injections of shorter acting androgen esters. We, therefore, sought to define the prevalence, predictors, and proximate basis (role of erythropoietin) for polycythemia (hematocrit >0.50) in hypogonadal men receiving testosterone implants long term.. A cross-sectional study was conducted in an academic andrology center with a longitudinal subgroup analysis.. A total of 158 hypogonadal men aged 14-84 years (mean age 46.7 years) treated on average for 8 years (range 0-21 years).. Trough blood testosterone and hematocrit. Serial serum erythropoietin concentrations were measured in 16 volunteers.. Positive univariate associations between polycythemia (hematocrit >0.50) and log(testosterone) (odds ratio (OR) 24.7, 95% confidence interval (CI): 4.3, 141.2, P<0.01) and age (OR 1.1, 95% CI: 1.0, 1.1, P=0.03) and a borderline relationship with current smoking (OR 4.2, 95% CI: 0.9, 20.0, P=0.08) were unveiled. A sensitivity analysis using alternate definitions of polycythemia was performed to capture all potential covariants. Multivariate regression analysis incorporating all potential covariants disclosed the independent OR of developing polycythemia (after adjusting for smoking and age) for log(testosterone) to be 15.0 (95% CI: 2.5, 90.8). Duration of testosterone therapy did not alter the risk of polycythemia. A direct relationship between testosterone and erythropoietin was observed (P=0.05).. Higher trough serum testosterone concentrations but not duration of treatment predict the development of polycythemia in men receiving long-acting depot testosterone treatment.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Androgens; Drug Implants; Erythropoietin; Hematocrit; Humans; Hypogonadism; Injections, Subcutaneous; Logistic Models; Longitudinal Studies; Male; Middle Aged; Multivariate Analysis; Polycythemia; Predictive Value of Tests; Prevalence; Testosterone; Young Adult

To assess in vitro erythropoietic cultures as a tool to discriminate between patients whose anemia improves with and those whose anemia fails to improve with androgens, bone marrows of 24 anemic patients receiving maintenance hemodialysis in hormone-depleted plasma clots were cultured. While erythroid colony proliferation in the presence and absence of androgens by cells of seven patients with good clinical outcomes who were initially studied was similar to that of normal donors, it was reduced (P less than 0.001) in cultures of cells from seven patients whose clinical responses were ultimately poor. Fewer than 25 colonies/6 X 10(4) cells at optimal erythropoietin concentrations, and less than a 25% enhancement in colony growth by androgens were observed in only those cultures derived from clinical nonresponder marrows. Using these criteria, nine of ten prospectively classified patients (five clinical responders and four nonresponders) were identified correctly.

Topics: Adult; Aged; Androsterone; Colony-Forming Units Assay; Erythropoiesis; Erythropoietin; Female; Fluoxymesterone; Humans; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Nandrolone; Nandrolone Decanoate; Renal Dialysis; Testosterone; Testosterone Congeners