Testosterone deficiency is highly prevalent in men with chronic kidney disease (CKD), affecting 30–70% of patients depending on disease stage and diagnostic criteria. Despite its frequency and association with adverse outcomes including anemia, malnutrition, muscle wasting, cardiovascular disease, and impaired quality of life, testosterone replacement therapy (TRT) remains underutilized in this population. This review synthesizes evidence from randomized controlled trials, prospective registries, and observational studies demonstrating that TRT in CKD patients produces clinically meaningful improvements in hematologic parameters, nutritional markers, muscle strength, body composition, sexual function, and quality of life.
