Testosterone Replacement Therapy (TRT) is commonly used to treat low testosterone, improving symptoms like fatigue, depression, and mood swings. But before jumping in, it’s a good idea to know how TRT might affect your kidneys, especially if you have kidney issues or just one kidney. Understanding these potential effects will help you make the best decision for your health.
How are testosterone and kidneys connected?
Testosterone isn’t just about muscle growth and energy—it affects the kidneys too. Although often seen as the "male hormone," testosterone is important for everyone, regardless of gender identity or expression.
People with chronic kidney disease (CKD) or end-stage renal disease (ESRD) often have lower testosterone levels than those with normal kidney function. In fact, studies show this drop in testosterone is common in people with CKD and can lead to symptoms like muscle weakness, fatigue, and mood swings.
TRT can help by increasing those testosterone levels, potentially improving some of these symptoms. If you have CKD or ESRD, TRT might give you a bit more energy and help with muscle weakness—both of which are common in kidney disease.
What does TRT do to kidney function?
This is where things get a bit tricky. On one hand, TRT can help strengthen your muscles and improve your overall physical function. Stronger muscles mean less strain on your body, which could indirectly help your kidneys. In fact, a 2024 International Journal of Impotence Research study found that some people who have undergone kidney transplants report feeling better with TRT.
Still, according to research published in the journal BMC Medicine, TRT may raise blood pressure and increase red blood cell count, both of which can put extra stress on the kidney. The long-term effects of TRT on kidney function are still being investigated, but a 2021 Annals of Medicine and Surgery study discovered it can show an increase in glomerular filtration rate—or GFR—which is the standard measure of kidney function. Another study, published in Annals of Nephrology, suggests TRT can potentially delay the progress of chronic kidney disease.
One thing to keep in mind is that TRT increases muscle mass, which also raises creatinine levels. Doctors, then, need to be careful when interpreting creatinine results for people with CKD who are on testosterone therapy. This increase could reflect muscle growth rather than kidney damage.
The bottom line
If you're thinking about TRT and have concerns about your kidney health, the best move is to chat with your healthcare provider. They can keep an eye on your kidney function and blood pressure to make sure TRT is safe for you. It’s also good to keep them updated on any changes in how you feel.
The takeaway? TRT can be helpful for managing low testosterone, but if you have kidney concerns, it’s important to weigh the benefits and risks with your doctor’s guidance. Together, you can figure out the best approach for your health.
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