Population with chronic kidney disease (CKD) has had many problems, and some of these have arisen from sexual disorders. The present study intends to determine the prevalence and the associated factors with erectile dysfunction (ED) among patients with CKD on conservative treatment (CKDCT). This transversal study was conducted from May 2013 to December 2015. The tools used were: medical records and the International Index of Erectile Function. Data were analyzed by univariate and multivariate logistic regression analysis. Among 245 patients that have participated of this study, ED was present in 71.02% and it was severe in 36.73%. Age greater than 50 years, body mass index lower than 25, diabetes mellitus, stages IV/V of CKD, cardiac conduction disturbances, benign prostatic hyperplasia, smoking, alcohol use, albumin <3.5 g per 100 ml and creatinine clearance between 15 and 29 ml min−1 per 1.73 m2 were associated with ED. Time of CKD was the only variable associated with ED independent of the presence of other factors. ED prevalence in patients with CKDCT is high and it is severe in more than half of them. Several factors are associated with ED in this population but the principal one is the time of CKD.
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National Institutes of Health Consensus Development Panel on Impotence. Impotence. JAMA 1993; 270: 83–90.
Castro RP, Hernández PC, Casilda RR, García JR, Tapia MJ . Epidemiology of erectile dysfunction. Risk factors. Arch Esp Urol 2010; 63: 637–639.
Ayta IA, McKinlay JB, Krane RJ . The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999; 84: 50–56.
Bellinghieri G, Santoro D, Satta E, Savica V . Erectile dysfunction and quality of life in patients with chronic renal failure. G Ital Nefrol 2008; 25: 713–717.
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Perelman MA . Erectile dysfunction and depression: screening and treatment. Urol Clin North Am 2011; 38: 125–139.
Levy NB . Sexual adjustment to maintenance hemodialysis and renal transplantation: national survey by questionnaire: preliminary report. Trans Am Soc Artif Intern Organs 1973; 19: 138–143.
Esen B, Kahvecioglu S, Atay AE, Ozgen G, Okumus MM, Seyahi N et al.. Evaluation of relationship between sexual functions, depression and quality of life in patients with chronic kidney disease at predialysis stage. Ren Fail 2015; 37: 262–267.
Canat L, Canat M, Guner B, Gurbuz C, Caşkurlu T . Association between renal function, erectile function and coronary artery disease: detection with coronary angiography. Korean J Urol 2015; 56: 76–81.
Mesquita JFP, Ramos TF, Mesquita FP, Netto JMB, Bastos MG, Figueiredo AA . Prevalence of erectile dysfunction in chronic renal disease patients on conservative treatment. Clinics 2012; 67: 181–183.
Cerqueira J, Moreas M, Glina S . Erectile dysfunction: prevalence and associated variables in patients with chronic renal failure. Int J Impot Res 2002; 14: 65–71.
Rosas SE, Joffe M, Franklin E, Strom BL, Kotzker W, Brensinger C et al. Prevalence and determinants of erectile dysfunction in hemodialysis patients. Kidney Int 2001; 59: 2259–2266.
Stolic RV, Bukumiric ZM . Intima-media thickness of carotid arteries and erectile dysfunction in hemodialysis patients. Hemodial Int 2010; 14: 510–514.
Malekmakan L, Shakeri S, Haghpanah S, Pakfetrat M, Sarvestani AS, Malekmakan A . Epidemiology of erectile dysfunction in hemodialysis patients using IIEF questionnaire. Saudi J Kidney Dis Transpl 2011; 22: 232–236.
Messina LE, Claro JA, Nardozza A, Andrade E, Ortiz V, Srougi M . Erectile dysfunction in patients with chronic renal failure. Int Braz J Urol 2007; 33: 673–678.
Papadopoulou E, Varouktsi A, Lazaridis A, Boutari C, Doumas M . Erectile dysfunction in chronic kidney disease: From pathophysiology to management. World J Nephrol 2015; 4: 379–387.
Seck SM, Dahaba M, Diouf B, Cisse MM, Gueye S, Ka EF et al. The burden of erectile dysfunction in dialysis patients in Senegal. Hemodial Int 2011; 15: 280–283.
Derby CA, Barbour MM, Hume AL, McKinlay JB . Drug therapy and prevalence of erectile dysfunction in the Massachusetts Male Aging Study cohort. Pharmacotherapy 2001; 21: 676–683.
Jackson G, Padley S . Erectile dysfunction and silent coronary artery disease: abnormal computed tomography coronary angiogram in the presence of normal exercise ECGs. Int J Clin Pract 2008; 62: 973–976.
Chiurlia E, D’Amico R, Ratti C, Granata AR, Romagnoli R, Modena MG . Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol 2005; 46: 1503–1506.
Inci K, Hazirolan T, Aki FT, Oruc O, Tombul T, Tasar C et al.. Coronary artery calcifications in hemodialysis patients and their correlation with the prevalence of erectile dysfunction. Transplant Proc 2008; 40: 77–80.
Collaborative Depression and Sexual dysfunction (CDS) in Hemodialysis Working Group. Prevalence and correlates of erectile dysfunction in men on chronic haemodialysis: a multinational cross-sectional study. Nephrol Dial Transplant 2011; 0: 1–10.
Naya Y, Soh J, Ochiai A, Mizutani Y, Ushijima S, Kamoi K et al. Significant decrease of the International Index of Erectile Function in male renal failure patients treated with hemodialysis. Int J Impot Res 2002; 14: 172–177.
Neto AF, Rodrigues MAF, Fittipaldi JAS, Moreira ED Jr . The epidemiology of erectile dysfunction and its correlates in men with chronic renal failure on hemodialysis in Londrina, southern Brazil. Int J Impot Res 2002; 14: S19–S26.
National Kidney Foundation. NKF-DOQI clinical practice guidelines for hemodialysis adequacy. National Kidney Foundation. Am J Kidney Dis 1997; 30: S15–S66.
Procci WR, Goldstein DA, Adelstein J, Massry SG . Sexual dysfunction in the male patient with uremia: a reappraisal. Kid Int 1981; 19: 317–323.
Breza J, Reznicek J, Pribylincova V, Zvara P . Erectile dysfunctions in patients treated with hemodialysis and kidney transplantation. Bratisl Lek Listy 1993; 94: 489–493.
Bellinghieri G, Savica V, Santoro D . Vascular erectile dysfunction in chronic renal failure. Semin Nephrol 2006; 26: 42–45.
Abobakr R, Alakhras A, Eyada M, Al-Yahiri M . Etiopathogenic types of erectile dysfunction in chronic kidney disease patients. J Urol 2011; 185: e528.
Costa MR, Reis AMB, Pereira BP, Ponciano VC, Oliveira EC . Associated factors and prevalence of erectile dysfunction in hemodialysis patients. IBJU 2014; 40: 44–55.
Ali ME, Abdel-Hafez HZ, Mahran AM, Mohamed HZ, Mohamed ER, El Shazly AM et al. Erectile dysfunction in chronic renal failure patients undergoing hemodialysis in Egypt. Int J Impot Res 2005; 17: 180–185.
Lasker GF, Maley JH, Kadowitz PJ . A review of the pathophysiology and novel treatments for erectile dysfunction. Adv Pharmacol Sci 2010; 2010: pii:730861.
Cloostermans L, Wendel-Vos W, Doornbos G, Howard B, Craig CL, Kivimäki M et al. Independent and combined effects of physical activity and body mass index on the development of Type 2 Diabetes – a meta-analysis of 9 prospective cohort studies. Int J Behav Nutr Phys Act 2015; 12: 147.
Molnar MZ, Carrero JJ, Mucsi I, Remport A, Rhee CM, Kalantar-Zadeh K et al.. Comparison of the malnutrition-inflammation score in chronic kidney disease patients and kidney transplant recipients. Int Urol Nephrol 2015; 47: 1025–1033.
Toda K, Miwa Y, Kuriyama S, Fukushima H, Shiraki M, Murakami N et al. Erectile dysfunction in patients with chronic viral liver disease: its relevance to protein malnutrition. J Gastroenterol 2005 Sep; 40: 894–900.
Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med 2010; 7: 445–475.
Fryckstedt J, Hylander B . Sexual function in patients with end-stage renal disease. Scand J Urol Nephrol 2008; 42: 466–471.
Rathi M, Ramachandran R . Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology. Indian J Endocrinol Metab 2012; 16: 214–219.
Baylis C . Arginine, arginine analogs and nitric oxide production in chronic kidney disease. Nat Clin Pract Nephrol 2006; 2: 209–220.
Chuang YC, Chung MS, Wang PW, Lee WC, Chen CD, Chang HW et al. Albuminuria is an independent risk factor of erectile dysfunction in men with type 2 diabetes. J Sex Med 2012; 9: 1055–1064.
Hermans MP, Ahn SA, Rousseau MF . Erectile dysfunction, microangiopathy and UKPDS risk in type 2 diabetes. Diabetes Metab 2009; 35: 484–489.
Platek AE, Hrynkiewicz-Szymanska A, Kotkowski M, Szymanski FM, Syska-Suminska J, Puchalski B et al.. Prevalence of erectile dysfunction in atrial fibrillation patients - a cross-sectional, epidemiological study. Pacing Clin Electrophysiol 2015; 39: 28–35.
Kimoto Y. Epidemiology of ED and risk factors. In: Naito O (ed). Outpatient Clinic of Urology, Series 6: Outpatient Clinic of Erectile Dysfunction,1st edn, 2000, pp 10–15.
Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M . Engelmann. Epidemiology of erectile dysfunction: Results of the ‘Cologne Male Survey’. Int J Impot Res 2000; 12: 305–311.
Shimizu S, Tsounapi P, Shimizu T, Honda M, Inoue K, Dimitriadis F et al.. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: Are these conditions related to vascular dysfunction? International Journal of Urology 2014; 21: 856–864.
Cao S, Gan Y, Dong X, Liu J, Lu Z . Association of quantity and duration of smoking with erectile dysfunction: a dose-response meta-analysis. J Sex Med 2014; 11: 2376–2384.
Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI . Effects of cigarette smoking on erectile dysfunction. Andrologia 2014; 47: 1087–1092.
Stolic RV, Bukumiric ZM, Jovanovic AN, Peric VM, Sovtic SR, Belic BP et al.. Residual renal function and erectile dysfunction in patients on hemodialysis. Int Urol Nephrol 2012; 44: 891–895.
Muniz JJ, Leite LN, De Martinis BS, Carneiro FS, Tirapelli CR . Chronic ethanol consumption induces erectile dysfunction: Role of oxidative stress. Life Sci 2015; 141: 44–53.
Mannino DH, Klevens RM, Flanders WD . Cigarette-smoking: An independent risk factor for impotence. Am J Epidemiol 1994; 140: 1003–1008.
Tian Ye JiZG, Tang YW, Zhang L, Lü WC, Lin J et al. Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey. Chin Med J 2008; 121: 795–799.
The authors declare no conflict of interest.
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Costa, M., Ponciano, V., Costa, T. et al. Prevalence and factors associated with erectile dysfunction in patients with chronic kidney disease on conservative treatment. Int J Impot Res 29, 219–224 (2017). https://doi.org/10.1038/ijir.2017.20
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