-Original-

Late-Onset Hypogonadism in Male Hemodialysis Patients: Association with Statin Therapy and Cholesterol Levels

Hiroyuki Fujinami¹, Tadasuke Ando², Nobuhito Shibahara³, Yoshitsugu Fujita⁴ and Toshitaka Shin¹

¹Department of Urology, Faculty of Medicine, Oita University, Oita, Japan
²Organ Transplant Promotion Project, Faculty of Medicine, Oita University, Oita, Japan
³Faculty of Medicine, Oita University, Oita, Japan
⁴Hemodialysis Center, Nankai Medical Center, Oita, Japan

Background: Late-onset hypogonadism (LOH), a condition characterized by age-related testosterone decline, is associated with impaired quality of life and adverse clinical outcomes. Although endocrine abnormalities are common in patients undergoing maintenance hemodialysis (MHD), the clinical characteristics and risk factors for LOH in this population remain unclear. This study investigated the prevalence of LOH and its associated clinical factors in male patients on MHD.
Methods: Sixty-nine male patients undergoing MHD were enrolled. LOH was defined as total testosterone ≤250 ng/dL combined with an Aging Male Symptoms Score (AMSS) of ≥27. Clinical features, laboratory parameters, and medication use were compared between patients with and without LOH. Factors associated with LOH were evaluated using multivariate analysis.
Results: Fifteen patients (21.7%) met the diagnostic criteria for LOH. Patients with LOH had significantly higher AMSS scores, particularly in the sexual domain. In the revised multivariate analysis excluding variables used in the definition of LOH, statin use remained independently associated with LOH (odds ratio: 8.12, p = 0.017), whereas total cholesterol showed a marginal inverse association (odds ratio: 0.97, p = 0.058).
Conclusions: LOH was observed in approximately 20% of male patients on MHD and was characterized mainly by sexual symptoms. Statin therapy may be associated with LOH; however, the findings should be interpreted cautiously due to potential confounding and limited sample size.

J Nippon Med Sch 2026; 93: 297-303

Keywords
late-onset hypogonadism, maintenance hemodialysis, statins, total testosterone, cholesterol

Correspondence to
Tadasuke Ando
chyusuke@oita-u.ac.jp

Received, March 14, 2026
Accepted, April 10, 2026