Endocrine Abstracts

Chronic kidney disease (CKD) is a global burden, with prevalence of 11–13%. CKD usually remains asymptomatic until later stages, but is strongly associated with increased risks of cardiovascular morbidity, premature mortality and decreased quality of life. Kidney transplantation (KT) is a treatment of choice for end stage CKD. KT was performed 350 times from dead donor and 6 times from living donor in the GU ‘Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology’ in 2018. Objective – Evaluate menstrual function and reproductive state in women after KT. Patients’ history was collected by interview and physical examination, hormone levels were determined by ELISA. Ethics Committee approved the study. All patients signed written informed consent. Research group includes 34 women of age 36.4 ± 5.8 who had undergone KT within last 6 years. Patients have adequate graft function confirmed by serum creatinine, urea, cystatine C levels and GFR and are observed by nephrologist regularly. Patients get immunosuppressive medications (Medrol-Ciclosporin/Azathioprin/Tacrolimus- Mucophenolate mofetil) in 2 or 3 component treatment regime and had no complications or concomitant diseases at the time of the study. Women who had severe infections, were pregnant or had complications in graft functioning were excluded from the study. Control group consisted of 27 healthy women. Measures showed 27 patients had menstrual disturbances, the most common oligo- and amenorrhea that depended from age and time that a patient had spent on the dialyses. Average levels of estradiol, Ingibin B, Antimullerian hormone, progesterone, LH and FSH measured in the luteal phase were comparable with no significant difference between two groups. Serum prolactin levels were higher in kidney recipients that in controls (P = 0.01) with the ranges 693.5 ± 267.7 mIU/l (KT) and 510.0 ± 271.8 mIN/l (healthy women). Testosterone and free testosterone levels we significantly lower in women after KT than in control ones. 25(OH)D status remained below recommended threshold in both groups that was explained by the autumn/winter time of the study. Significant difference was found in levels of LH mediana and FSH mediana in the follicular phase. Women after transplantation suffer from irregular menses, hyperprolactinemia, low levels of testosterone. Different hypotheses suggest connection between immunosuppressive therapy, dialyses time, graft function and obtained data that needs further investigation.