EVALUATION OF THE HYPOTHALAMIC-PITUITARY AXIS IN UREMIC MALES USING DYNAMIC TESTS - THE POSSIBLE ROLE OF TESTICULAR INHIBIN - A PRELIMINARY-REPORT

Two dynamic tests (Gn-RH i. v. and clomiphene citrate-CC p.o.) were us ed to evaluate the hypothalamic-pituitary axis in hemodialysis patient s and renal transplant recipients (recipients). In the Gn-RH test the gonadotropin secretion was maximally decelerated in hemodialysis patie nts while it was normal in recipients. During the CC test a decrease o f gonadotropin secretion, chronically and quantitatively identical for both group, was found; while on the following test days an increase w as noted, which was more accelerated in male recipients. In cases with uremia a strong negative feedback dominates at the pituitary level pr obably owing to testicular inhibin. The estrogenic feedback in uremia was intact, while the antiestrogenic feedback at the level of hypothal amus is partly impaired, owing to altered opioid metabolism.