Association of TRT with Atrial Fibrillation and Acute Kidney Injury

madman

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Panken, E1; Greenberg, DR1; Kohn, Md , T2; Asanad, Md , K1; Brannigan, Md , RE1; Halpern, JA1

1 - Northwestern University, Feinberg School of Medicine
2 - The Brady Urologic Institute, Johns Hopkins School of Medicine



Introduction:

Secondary analyses of the Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) trial revealed significantly higher rates of new-onset atrial fibrillation (AF) and acute kidney injury (AKI) in the TRT cohort.


Objective:

To validate the secondary findings of the TRAVERSE trial.


Methods:

We utilized the TriNetX Research Network to identify a cohort of men ages 45-80 years old who met similar inclusion criteria to the TRAVERSE trial. We compared hypogonadal men (testosterone 100-300 ng/dL) who had a prescription for topical testosterone therapy and men who did not. Propensity score matching was used to match patient populations. Kaplan Meier survival analysis was used to determine the relative risk of new-onset AFIB and acute kidney injury (AKI) within 3 years.


Results:

There were 2,134 men included in each cohort after propensity score matching. There was no significant difference in age or race/ethnicity between cohorts. Men on TRT had significantly lower T at the time of diagnosis compared to men not prescribed TRT (207 ± 66 ng/dl vs 246 ± 140 ng/dl, p<0.001). Kaplan-Meier survival analysis showed a significantly increased risk AKI among men on TRT (RR 1.53, 95% CI 1.07-2.18). However, TRT was not associated with a significantly increased risk of new-onset AF (RR 1.48, 95% CI 0.93-2.37).


Conclusions:

Similar to the TRAVERSE trial, our study demonstrated an increased risk of AKI among men on TRT, but did not find an increased risk of AF. Further studies are required to validate these findings.


Disclosure:
Any of the authors act as a consultant, employee or shareholder of an industry for: Posterity Health
 
Is there some way to tell if they corrected for blood pressure or some form of Rhabdo for the AKI finding? I've never heard of TRT alone having a mechanism for kidney injury, whether chronic or acute. One would think that this would have been major issue in the physique and/or strength community if that was a real risk.
 

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A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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