You are here:

Nephrology/PKD & Testosterone Replacement Therapy


Hello Dr. Shah.  
My husband is 38 with PKD.  He is at a very stable point in his disease, as his kidney function is still good.  His main issues are high blood pressure, for which he takes two medicines (amlodipine & losartan HCTZ), and the occasional (roughly every two years) ruptured cyst and subsequent infection.  He is about 40 lbs overweight and recently had his annual lab work run.  His nephrologist felt that based on his low energy, gynecomastia, etc., he should have his testosterone tested as well.  His results are in, and his T is below the lowest number on the "normal range" at his lab. He is at (I believe) 220ish.  

His nephrologist referred him to see a urologist for HRT.  However, I am concerned that replacement testosterone may have a negative impact on his kidney disease's cysts, function, etc.  

Have you ever heard of any such connection between T - HRT and male PKD patients?  

Thank you for your time and information.


Thanks for asking my opinion on Allexperts.

Androgens have been implicated in mediating disease escalation in autosomal dominant polycystic kidney disease (ADPKD). Animal experiments have shown that androgens potentiate renal cell proliferation and cyst enlargement through ERK1/2-dependent and ERK1/2-independent signaling mechanisms.

I could not come across similar published literature in humans, but I would be very cautious in prescribing androgens to patients who have CKD due to ADPKD.

Please discuss these issues with your Nephrologist.


Dr. Shah


All Answers

Answers by Expert:

Ask Experts


Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow


I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

Alternative Website


Ten years as a Critical Care & Transplant Nephrologist

International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association

- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182

MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

©2016 All rights reserved.