ERECTILE DYSFUNCTION IN HAEMODIALYSIS PATIENTS
Abstract
Background and Objective: There is a very high prevalence of Erectile Dysfunction (ED) in dialysispatients. There is no as such available data on ED and factors affecting it in our patients. Methods:Analytical, cross-sectional, hospital based study conducted from January to March 2008,Haemodialysis unit of Shalimar and Mayo Hospital, Lahore. All male patients of end stage renaldisease (ESRD) on maintenance haemodialysis therapy, whose spouses are alive and able to performintercourse, were included in the study. Patient with cognitive and communication deficits wereexcluded from study. International index of erectile function-5 (IIEF-5), adopted in Urdu was used forthe determination of prevalence of erectile function. Categorization of erectile dysfunction was done asmild, moderate and severe. Demographic data were collected and certain laboratory parameters(haemoglobin, haematocrit, urea, HBsAg and Anti HCV) were sent. Results: Total numbers of patientwere fifty. Major cause of ESRD was diabetes mellitus 28 (56%). Most of the patients 33 (66%) havepassed 10th grade or they were under 10th grade. Prevalence of ED was 86% with mean IIEF-5 score of10.36±7.13. Majority of patients 33 (64.7%) were suffering from severe degree of ED. Factorsresponsible for ED are diabetes mellitus, age more than 50 year, high pre dialysis urea and Anti HCVpositive patients. In this study, smoking, duration of dialysis and monthly spending is not related withED. Conclusion: Majority of the patients suffering from ESRD, on maintenance haemodialysis arehaving ED. None of the patients suffering from ED were taking any treatment for it. Haemodialysisdoes not improve sexual dysfunction. Major factors responsible for ED are diabetes mellitus, age morethan 50 years, high pre dialysis urea and Anti HCV positive patients.Keywords: Haemodialysis, erectile dysfunction, diabetes mellitus, age, IIEF-5References
Palmer BF. Sexual dysfunction in men and women with
chronic kidney disease and end-stage idney disease. Adv Ren
Replace Ther. 2003 2003;10(1):48–60.
Diemont WL, Vruggink PA, Meuleman EJ, Doesburg
WH, Lemmens WA, Berden JH. Sexual dysfunction after renal
replacement therapy. Am J Kidney Dis 2000;35:845–51.
Finkelstein FO, Shirani S, Wuerth D, Finkelstein SH.
Therapy Insight: sexual dysfunction in patients with chronic
kidney disease. Nat Clin Pract Nephrol 2007;3:200–7.
Leu TF. Erectile Dysfunction. N Eng J Med 2000;342:1802–13.
Roses SE, Joffe M , Franklin E, Strom BL, Kortzher W,
Brensinge C, et al. Prevalence and determinants of ED in
hemodialysis patients. Kidney Int 2001;59:2259–66.
Turks, karallezlib, Tonbultiz, Yildiz M, Altintepec, Yildiz A.
Erectile Dysfunction and the effects of sildenafil treatment
in patients of hemodialysis and continuous ambulatory
peritoneal dialysis. Nephro Dial Transplant 2001;6:1818–22.
Rosen R, Cappelleri J, Smith M, Lipsky J, Peña BM.
Development and evaluation of an abridged, 5-item, version
of the IIEF as a diagnostic tool for erectile dysfunction. Int J
Impot Res 1999;11:319–26.
Khan MH. Standardization and Validation of Urdu version of
International Index of Erectile Function presented at first
congress of world association of sexual health held at Sydney
in April 15–19, 2007. Published in abstract book reference
OPI-14 p115.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick
J, Mishra A. The International Index of Erectile Function
(IIEF): A multidimensional scale for assessment of erectile
dysfunction. Urology 1997;49:822–30.
Rosas SE, Jeffe M, Franklin E, Kotzker W, Brensinger
C, Grossman E, et al. Association of decreased quality of life
and erectile dysfunction in hemodialysis patients. Kidney Int
; 64:232–8.
Mehrsai S, Mousai M, Xthoobonkt T, Khanlarpoor L,
Shekarpoor, Pourmand. Improvement of erectile dysfunction
KTP. Urology Journal. 2006;3(4):240–3.
Inci k, Hazirolan T, Ati FT, Oruc O, Tombul T, Tasar
C,Erkan L, et al. Coronary artery calcification in HD
patients and their correlation with the prevalence of ED.
Transplant Proc 2008;40(1):77–80.
Ali ME, Abdel-Hafeez HZ, Mahran AM, Mohammad HZ,
Mohammad ER, EL-Shazalay AM. Erectile function in
chronic renal failure patients undergoing hemodialysis in
Egypt. Int J Impoten Res 2005;17(2):180–5.
Neto AF, de Freitac Rodrigness MA, Saraira Fitti pal di JA,
Moreirer ED Jr. The epidemiology of ED and its correlation in
men with chronic renal failure on hemodialysis in Londrina,
Southern Brazil. Int J Impot Res 2002;14(2):S19–26.
Kashimaki J, Shiri R, Tammela T, Hakkinen j, Hakkama M.
Regular intercourse protects against erectile dysfunction:
Tempere Aging Male Urologic Study. Am J Med. Med
;121(7): 592-6.
Miyata Y, Shindo K, Matsuya F, Noguchi M, Nishikido M,
Koga S, et al. Erectile dysfunction in hemodialysis patients
with diabetes mellitus: association with age and hemoglobin
a1c levels. Intewrnational J Urol 2004;11(7):530–4.
Mersdorf A, Goldsmith PC, Diederichs W, Padula CA, Lue
TF, Fisherman U, et al. Ultrastructural changes in impotent
penile tissues. A comparison of 65 patients. J Urol
;145:749–58.
Cartledge JJ, Eardley L, Morrison JFB. Nitric oxide mediated
corpus cavernosal smoth muscle relaxation is impaired in ageing
and diabetes. BJU Int 2001;87:394–401.
Klein R, Klein Bek Lee, Moss SE, Cruickshanks KJ.
Prevalence of self reported erectile dysfunction in people
with long term IDDM. Diabetes Care 1996;19:135–41.
Feldman HA, Goldstein I, Hatzichristen DC, Krane
RJ, McKinlay JB. Impotence and its medical and
psychological correlates. Results of the Massacheesetts Male
aging study. J Urol 1994;151:54–61.
Rodger RS, Fletcher K, Dewar JH, Genner D, McHugh
M, Wilkinson R, et al. Prevalence and pathogenesis of
impotence in one hundred uremic men. Uremia Invest
;8:89–96.
Chun Fu Lia, Yu- Ting Wamg, Kuan-Yu Hung, Yu-Sen
Peng, Yih-Ron Lien, Ming-Chion Wu, et al. Sexual
Dysfunction in peritoneal dialysis patients. Am J Nephrol
;27(6):615–21.
Tobias S. Kohler, Johnnykim, Kendall Feia, Josh Bodie,
Nick Johnson, Antonine Makhloul, et al. Prevalence of
androgen deficiency in men with Erectile Dysfunction.
Urology 2008;71(4):693–7.
Yavuz BB, Ozkayar N, Halil M, Cankurtaran M, Ulger Z,
Tezlan E, et al. Free testosterone levels and implication in
clinical outcomes in elderly man. Aging Clinical Exp Rest
;20(3):201–6.
Paolo ND, Capotonodo L, Gaggiotti F, Rossi P. Sexual
Function in uremic patients. Contrib Nephrol. 1990;77:34–44.
Steele TE, Wuerth D, Finkelstein S, Juergensen D,
Juergensen P, Kliger AS, et al. Sexual experience of the
chronic peritoneal dialysis patients. J Am Soc Nephrol
;7:1165–8.
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