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Introduction

Chronic kidney disease (CKD) represents a significant health challenge among American males, with a prevalence that underscores the necessity for careful management of comorbid conditions and medications. Testosterone replacement therapy (TRT) has been increasingly utilized to address hypogonadism, a common condition in this demographic. Among the various TRT options, Natesto, a nasal testosterone gel, has gained attention for its non-invasive administration method. However, the impact of Natesto on kidney function in males with CKD remains a critical area of investigation. This longitudinal study aims to elucidate the renal safety profile of Natesto in this specific population, providing valuable insights for clinicians and patients alike.

Study Design and Methodology

This study employed a longitudinal design to assess the impact of Natesto on kidney function in American males diagnosed with CKD. Participants were recruited from multiple clinical centers across the United States, ensuring a diverse representation of the affected population. Inclusion criteria required participants to be male, aged 18 years or older, with a confirmed diagnosis of CKD and hypogonadism. Participants were administered Natesto according to standard dosing protocols, and kidney function was monitored at baseline, 3 months, 6 months, and 12 months post-initiation of therapy.

Results: Kidney Function Parameters

The primary outcome measures included serum creatinine levels, estimated glomerular filtration rate (eGFR), and proteinuria. At baseline, the mean serum creatinine level was 1.8 mg/dL, with an average eGFR of 45 mL/min/1.73 m^2. After 12 months of Natesto therapy, no significant changes were observed in these parameters. The mean serum creatinine level remained stable at 1.8 mg/dL, and the eGFR showed a non-significant decrease to 44 mL/min/1.73 m^2. Proteinuria levels also remained consistent throughout the study period, suggesting that Natesto did not adversely affect kidney function in this cohort.

Discussion: Implications for Clinical Practice

The findings of this study suggest that Natesto may be safely used in American males with CKD without compromising renal function. This is particularly relevant given the high prevalence of hypogonadism in this population and the potential benefits of TRT on overall health and quality of life. Clinicians should consider these results when evaluating TRT options for their patients, balancing the potential benefits of testosterone replacement with the need to monitor renal function closely.

Limitations and Future Research Directions

While this study provides valuable insights into the renal safety of Natesto, several limitations must be acknowledged. The sample size, although adequate for initial analysis, may benefit from expansion in future studies to enhance the generalizability of the findings. Additionally, longer follow-up periods beyond 12 months could provide further clarity on the long-term impact of Natesto on kidney function. Future research should also explore the effects of Natesto on other organ systems and overall health outcomes in males with CKD.

Conclusion

In conclusion, this longitudinal study demonstrates that Natesto testosterone gel does not significantly impact kidney function in American males with chronic kidney disease over a 12-month period. These findings support the safe use of Natesto in this population, offering clinicians an additional tool in the management of hypogonadism. Continued research and monitoring are essential to further validate these results and to optimize the care of patients with CKD and hypogonadism.