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Second, kidney injury in diabetes appears to be related to glomerular hyperfiltration [93, 94], which is likely related to an excessive reabsorption of sodium in the proximal tubule, leading diminished delivery of sodium to the macula densa, and (via tubuloglomerular feedback) to afferent arteriolar dilatation [95, 96]

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A 28-year-old with normal hormones and healthy testes will likely respond very differently than a 45-year-old with low testosterone and metabolic syndrome

Inflammatory cells increase local oxidative stress as well, which damages hormone-producing cells and reduces their lifespan