Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Prognostic factors for the vascular components of erectile dysfunction in patients on renal replacement therapy

International Journal of Impotence Research volume 15, pages 44–52 (2003)Cite this article

Abstract

A total of 76 male patients on renal replacement therapy (RRT) were investigated. Erectile dysfunction (ED) was defined as insufficient erection during visual erotic stimulation (VES) or during sleep as measured with Rigiscan® and Erectiometer®. Data on medical history, physical examination, and laboratory variables were collected. Furthermore, penile pharmacological duplex ultrasonography (PPDU) was performed. Univariate and multivariate logistic regressions were used to determine prognostic values and to develop prognostic models. Independent prognostic factors for ED were the number of cardiovascular events, waist–hip ratio, body mass index, and acceleration time (AT) as measured with PPDU. Independent prognostic factors for an abnormal AT (>100 ms) were number of cardiovascular events, age category, and the presence of carotid bruits. Independent prognostic factors for insufficient veno-occlusion during PPDU were number of cardiovascular events and supine diastolic blood pressure. The vascular contribution to ED in patients on RRT is substantial. Data from medical history, limited physical examination, and PPDU contribute to the prediction of the vascular contribution to ED.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Diemont WL et al. Sexual dysfunction after renal replacement therapy. Am J Kidney Dis 2000; 35: 845–851.

    Article  CAS  Google Scholar 

  2. Baigent B, Burbury K, Wheeler D . Premature cardiovascular disease in chronic renal failure. Lancet 2000; 356: 147–152.

    Article  CAS  Google Scholar 

  3. Goodman WB et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000; 342: 1478–1483.

    Article  CAS  Google Scholar 

  4. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

  5. Janssen E et al. Validation of a psychophysiological Waking Erectile Assessment (WEA) for the diagnosis of male erectile disorder. Urology 1994; 43: 686–695.

    Article  CAS  Google Scholar 

  6. Vruggink PA et al. Enhanced pharmacological testing in patients with erectile dysfunction. J Androl 1995; 16: 163–168.

    CAS  PubMed  Google Scholar 

  7. Jonas U . Erectiometer®; ein einfacher und sicher Test in der Diagnostik der erektilen Impotenz. Aktvel Urol 1982; 13: 324–327.

    Article  Google Scholar 

  8. Slob AK, Blom JHM, van der Werff ten Bosch JJ . Erection problems in medical practice: differential diagnosis with relatively simple method. J Urol 1990; 143: 46–50.

    Article  CAS  Google Scholar 

  9. Meuleman EJH et al. Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992; 147: 51–56.

    Article  CAS  Google Scholar 

  10. Meuleman EJH, Diemont WL . Investigation of erectile dysfunction. Diagnostic testing for vascular factors in erectile dysfunction. Urol Clin North Am 1995; 22: 803–819.

    CAS  PubMed  Google Scholar 

  11. URL: http://www.whocc.no/atcdd.

  12. Okabe H et al. The penis is not protected — in hypertension there are vascular changes in the penis which are similar to those in other vascular beds. Int J Impot Res 1999; 11: 133–140.

    Article  CAS  Google Scholar 

  13. Hubert HB et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of patients in the Framingham Heart Study. Circulation 1983; 67: 968–977.

    Article  CAS  Google Scholar 

  14. Derby CA et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology 2000; 56: 302–306.

    Article  CAS  Google Scholar 

  15. Seidell JC et al. Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study. Am J Clin Nutr 2002; 74: 315–321.

    Article  Google Scholar 

  16. Han TS et al. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 25: 1401–1405.

    Article  Google Scholar 

  17. Davies KN, Humphrey PR . Do carotid bruits predict disease of the internal carotid arteries? Postgrad Med J 1990; 70: 433–435.

    Article  Google Scholar 

  18. Ingall TJ et al. Predictive value of carotid bruit for carotid atherosclerosis. Arch Neurol 1989; 46: 418–422.

    Article  CAS  Google Scholar 

  19. Benedetto FA et al. Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 2001; 12: 2458–2464.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Marloes Brok-Hamer, vascular technician, for her valuable contribution in the assessment of the penile pharmacological duplex ultrasonography and Monique Paardekooper-Fautubun for her expert secretarial and logistic support.

Author information

Authors and Affiliations

  1. Division of Nephrology, University Medical Center St Radboud Nijmegen, The Netherlands

    W L Diemont

  2. Department of Epidemiology and Biostatistics, University Medical Center St Radboud Nijmegen, The Netherlands

    J C M Hendriks

  3. Department of Epidemiology and Biostatistics, University Medical Center St Radboud Nijmegen, The Netherlands

    W A J G Lemmens

  4. Clinical Vascular Laboratory, University Medical Center St Radboud Nijmegen, The Netherlands

    H van Langen

  5. Division of Nephrology, University Medical Center St Radboud Nijmegen, The Netherlands

    J H M Berden

  6. Department of Urology, University Medical Center St Radboud Nijmegen, The Netherlands

    E J H Meuleman

Authors
  1. W L Diemont
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J C M Hendriks
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W A J G Lemmens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H van Langen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J H M Berden
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E J H Meuleman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W L Diemont.

Additional information

Funding: The research was funded by the Dutch Kidney Foundation (grant no. C93-1290).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Diemont, W., Hendriks, J., Lemmens, W. et al. Prognostic factors for the vascular components of erectile dysfunction in patients on renal replacement therapy. Int J Impot Res 15, 44–52 (2003). https://doi.org/10.1038/sj.ijir.3900946

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3900946

Keywords

Search

Advanced search

Quick links