摘要在终末期肾病患者中，下丘脑-垂体-性腺轴功能紊乱是导致性腺功能减退及性功能障碍的关键因素。肾移植手术是终末期肾病患者首选的治疗方法，对于改善肾移植受者的性腺功能障碍和性激素的异常有积极作用，但免疫抑制剂的不当使用会对性腺功能产生不良影响。因此，对于计划妊娠的女性肾移植受者，需要在权衡风险与收益的基础上，审慎调整免疫抑制药物的种类和剂量。磷酸二酯酶-5抑制剂、阴茎海绵体注射前列地尔及阴茎假体植入术在治疗男性肾移植受者勃起功能障碍方面已具备一定的安全性。然而总体来看，关于肾移植受者性腺功能减退的治疗研究尚显不足，亟待更多研究以探索更为有效的治疗方法。本文旨在深入探讨肾移植受者性腺功能变化的研究进展，为临床医生提供参考，以期为移植受者提供更优质的治疗方案。

abstractsDysfunction of the hypothalamic-pituitary-gonadal axis (HPGA) is a key contributor to hypogonadism and sexual dysfunction in patients with end-stage renal disease (ESRD). Kidney transplantation is the preferred treatment for ESRD and has demonstrated beneficial effects in improving gonadal dysfunction and abnormal sex hormone levels in transplant recipients. However, inappropriate use of immunosuppressants may have adverse effects on gonadal function. For female kidney transplant recipients planning pregnancy, careful adjustment of immunosuppressive regimens-balancing risks and benefits-is essential. In male kidney transplant recipients, phosphodiesterase-5 inhibitors, intracavernosal alprostadil injections, and penile prosthesis implantation have been shown to be relatively safe options for managing erectile dysfunction. Despite these advancements, research on the treatment of hypogonadism in kidney transplant recipients remains limited, underscoring the urgent need for further studies to explore more effective therapeutic approaches. This review aims to provide an in-depth analysis of research progress on gonadal function changes in kidney transplant recipients, offering valuable insights for clinicians to optimize patient management.