Possible role of elevated serum testosterone in pathogenesis of renal stone formation

BACKGROUND: Urolithiasis or renal stone formation occurs with three times higher frequency in males and decreases with age in parallel with the serum testosterone levels, suggesting a role played by male sex hormones. Androgens appear a promotion action and estrogens an inhibitory action on kidney stone formation in several animal models suggesting a study to be carried out to deduce the role played by serum testosterone in the formation of renal stones. AIM: The aim of this study is to define the involvement of serum total testosterone, free testosterone, and dihydrotestosterone in the pathogenesis of urolithiasis in males by comparing the results with healthy males with no present or past history of urolithiasis as controls. MATERIALS AND METHODS: A case–control study was undertaken with 108 participants: 78 males diagnosed with urolithiasis and 30 age-matched healthy males. RESULTS: The difference between mean age and body mass index of patients and controls were found to be nonsignificant. The total serum testosterone levels, serum dihydrotestosterone levels, were found to be higher in patients when compared to controls, and the difference was found to be significant. The levels of free testosterone and serum estradiol were also found to be higher in urolithiatic patients. CONCLUSION: The study demonstrates that elevated levels of serum testosterone and serum dihydrotestosterone might be involved in increased incidences of stone formation. The higher levels of estradiol do not seem to be a protective factor in males with urolithiasis with higher serum testosterone levels.