Table 1.
Summary of clinical studies included in meta-analysis.
| Author/year | Region | Study design | Patient types | Sample size | Age (years) | Comparison | Event number/adjusted HR (95% CI) | Follow-up (years) | Adjusted confounders | Overall NOS |
|---|---|---|---|---|---|---|---|---|---|---|
| Carrero et al. 2011 [17] | Turkey | Prospective cohort | Nondialysis CKD | 239 | 52.0 ± 12.0 | Per unit increase | CV events: 72; total testosterone: 0.83 (0.78–0.88); free testosterone: 0.65 (0.53–0.80) | 2.58 | Age, eGFR, diabetes, CVD, CRP, albumin, FMD | 5 |
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| Gungor et al. 2009 [18] | Sweden | Prospective cohort | HD | 126 | 63.0 ± 17.8 | Low vs. high | Total death: 65; 1.51 (0.86–2.72); CV death: 38; 2.00 (0.80–4.95) | 3.42 | Age, SHBG, diabetes, CVD, ACEI/ARB medication, IL-6, albumin, creatinine | 5 |
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| Yilmaz et al. 2010 [19] | Turkey | Prospective cohort | HD | 420 | 54 ± 13 | Lowest tertile 3 vs. highest | Total death: 104; 1.49 (0.83–2.66) | 2.67 | Age, BMI, HD duration, diabetes, CVD, albumin, creatinine, CRP | 7 |
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| Kyriazis et al. 2011 [20] | Greece | Prospective cohort | HD | 111 | 65 ± 12 | Low vs. high | Total death: 49; total testosterone: 2.81 (1.23–6.38); free testosterone: 2.62 (1.27–5.44); CV death: 28; total testosterone: 2.29 (0.78–6.72); free testosterone: 2.47 (0.92–6.64) | 3.08 | Age, BMI, CVD, HD vintage, CRP, albumin, PWV | 6 |
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| Khurana et al. 2014 [21] | America | Retrospective cohort | Nondialysis CKD | 2149 | 67.3 ± 11.3 | Lowest quintile 5 vs. highest | Total death: 357; 1.420 (0.995–2.020) | 2.3 | Age, BMI, race, smoking, eGFR, cerebrovascular disease, diabetes, hypertension, CAD, CHF, hyperlipidemia, albumin, malignancy, testosterone medication | 8 |
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| Bello et al. 2014 [22] | Canada | Prospective cohort | HD | 623 | 60.7 ± 15.2 | Lowest tertile 3 vs. highest | Total death: 166; 1.48 (0.62–1.66); CV events: 98; 1.38 (0.60–3.19) | 1.67 | Age, BMI, smoking, SHBG, cancer, diabetes | 6 |
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| Nakashima et al. 2017 [23] | Japan | Prospective cohort | HD | 902 | 63.4 ± 11.8 | Lowest tertile 3 vs. highest | Total death: 123; 2.26 (1.21–4.23); CV events: 151; 1.19 (0.74–1.91); infectious events, 116; 2.12 (1.18–3.79) | 2.06 | Age, BMI, albumin, creatinine, CRP, SHBG, ACEI/ARB medication; diabetes, history of CVD | 8 |
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| Yu et al. 2017 [24] | America | Retrospective cohort | HD and PD | 624 | 58 ± 14 | Lowest tertile 3 vs. highest | Total death: 108; 2.32 (1.33–4.06) | 1.2 | Age, race, diabetes; dialysis vintage, cause of ESRD, modality, dialysis access, CHF, CHD, albumin | 7 |
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| Wu et al. 2018 [25] | Taiwan | Retrospective cohort | HD | 137 | 71.7 ± 9.4 | Low vs. high | Total death: 61; 3.39 (1.67–6.86); CV death: 36; 6.13 (2.27–16.53) | 5.0 | Age, BMI, body composition, SMMI, diabetes, hypertension, albumin, creatinine, hemoglobin, CRP | 6 |
Unless specified, adjusted HR (95% CI) represents effect estimates of total testosterone. HR, hazard ratio; CI, confidence interval; HD, hemodialysis; PD, peritoneal dialysis; CKD, chronic kidney disease; CV, cardiovascular; BMI, body mass index; SMMI, skeletal muscle mass index; CRP, C-reactive protein; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor blocker; SHBG, sex hormone binding globulin; CVD, cardiovascular disease; CHF, congestive heart failure; ESRD, end-stage renal disease; CHD, coronary heart disease; FMD, flow-mediated dilation; eGFR, estimated glomerular filtration rate; CAD, coronary artery disease; and PWV, pulse wave velocity.