In a recent study published in the journal Scientific Reports, Researchers investigated the relationship between male infertility and kidney function. They used a large cohort that included 11,602 participants (5,494 childless men and 6,108 fathers). They found that childless men were more likely to have a low estimated glomerular filtration rate (< 60 ml/min/1.73m2) and dipstick proteinuria, regardless of age, socioeconomic status, or traditional renal risk factors such as hypertension, diabetes, and metabolic mode.
These findings contribute new evidence to a growing body of literature highlighting the role of male fertility in altering the risk or pathology of several noncommunicable chronic diseases. The study results suggest that men with reduced fertility may represent a population in need of routine renal function assessment.
Study: Prevalence of reduced renal function among childless men compared with fathers: a population-based study. Image credit: BigBlueStudio / Shutterstock
The non-reproductive effects of male infertility
Infertility has long plagued cultures around the world, with many traditions considering a person’s inability to reproduce a bad omen, curse, or divine punishment. Recent research suggests that while omens associated with male infertility have yet to be discovered, the risks of the condition may extend far beyond just reproduction or the reproductive system. Previous studies have identified infertile men with an increased risk of ischemic disease and diabetes.
Male infertility, a commonly invoked proxy for the much more difficult-to-explain male infertility, has been associated with cardiovascular risk factors such as hyperlipidemia, hyperglycemia, and hypertension, with these individuals significantly more likely than fertile men to consume prescription metabolic syndrome and hypertension medications. Unfortunately, research extending these investigations to renal assessments is still lacking. The present study aims to add to the work of Eisenberg et al., the only publication to date investigating the relationship between male infertility and kidney disease.
About the study
The purpose of the present study is to evaluate whether male infertility (hereafter a proxy for male infertility) is associated with reduced renal function (eGFR < 60 mL/min/1.73 m2) or dipstick proteinuria. The study sample cohort came from the Malmö Preventive Project (MPP), a long-term, longitudinal, population-based sample cohort established in the 1970s, with detailed information on creatinine levels and urine dipstick results necessary by measurement of glomerular filtration rate (eGFR) and dip test for protein in urine. The MPP also records and maintains the paternity status of participants, further meeting the requirements of the current study.
The MMP data revealed 22,444 men between the ages of 25 and 63 enrolled between 1974 and 1994. Data collection included socioeconomic, demographic, lifestyle, and medical history records obtained from participants via a generalized questionnaire. Experimental analyzes and characterizations were performed using urine samples submitted by the participants and physical examinations recorded by the author. The Swedish Statistical Tax Agency (STAS) provided data on the number of children per participant at baseline, with each record associated with a unique personal identification number.
Jaffe’s alkaline picrate assay and CKD-EPI creatinine formula (2021) were used to quantify serum creatinine concentrations and eGFR, respectively. Proteinuria was investigated using a semi-quantitative urine dip test. Finally, two logistic regression models were used to clarify any statistical associations (expressed as crude odds ratios [ORs]) between male infertility and eGFR and/or dipstick proteinuria. The first model accounted for men’s marital, socioeconomic, and occupational status, while the second adjusted for previously reported renal risk factors such as age, marital status, smoking status, and CKD-related comorbidities.
Study findings and conclusions
“In this population-based study we found that childless men, compared to fathers, are more prone to have signs of kidney disease, such as reduced eGFR and rod proteinuria. The probability of developing dipstick proteinuria, with or without a concomitant decline in eGFR, remained statistically significant even after adjustment for comorbidities and characteristics known to be associated with reduced renal function.”
Of the 22,444 participants initially screened from the MPP cohort, exclusion of individuals with missing data and those over 45 years of age resulted in a final cohort size of 11,602 individuals – 47.3% (n = 5494) were childless. eGFR assessments revealed that childless men (3.1%) were more likely to have an eGFR < 60 mL/min/1.73 m.2 from the corresponding fertile ones (2.3%). These findings were consistent with those found during dipstick assessments of proteinuria (7.1% in childless men and 4.9% in fathers). Surprisingly, these associations remained significant in all but one including the logistic regression model.
These findings highlight the increased risk of kidney disease of childless (infertile or infertile) men compared to Fathers, suggesting that the former are a target population for frequent renal monitoring, potentially presenting a new tool in the future arsenal of renal clinicians. illnesses.
