Kidney dysfunction
The mechanism by which renal dysfunction leads to gynecomastia is not very clear. A study indicates that renal dysfunction leads to disruption of hormone secretion at various levels; hypothalamus, pituitary and gonads. Overall, this disturbance lead to low levels of circulating testosterone, and hence, gynecomastia. The disturbance at the metabolic level of various metabolites, including urea, tends to play an important role not only in endocrine secretion, but also in metabolism of these hormones. However, even after treating this metabolic derangement with dialysis, the low level of testosterone persists. [7]