Prevalence and determinants of erectile dysfunction in hemodialysis patients

• Published in: Kidney international Vol. 59; no. 6; pp. 2259 - 2266
• Main Authors: Rosas, Sylvia E., Joffe, Marshall, Franklin, Eunice, Strom, Brian L., Kotzker, Wayne, Brensinger, Colleen, Grossman, Eric, Glasser, Dale, Feldman, Harold I.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2001; Nature Publishing; Elsevier Limited
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; chronic hemodialysis; Comorbidity; Cross-Sectional Studies; diabetes; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - epidemiology; Emergency and intensive care: renal failure. Dialysis management; end-stage renal disease; Erectile Dysfunction - epidemiology; Humans; Hypertension, Renal - epidemiology; IIEF-5; Intensive care medicine; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - therapy; Male; Medical sciences; men and HD; Middle Aged; Odds Ratio; Prevalence; Quality of Life; Renal Dialysis; Risk Factors; sexual health in men; men and HD; chronic hemodialysis; sexual health in men; end-stage renal disease; quality of life; diabetes; IIEF-5; Human; Kidney disease; Urinary system disease; Prevalence; Erection disorders; Pathophysiology; Hemodialysis; Impotence; Male; Epidemiology; Extrarenal dialysis; Chronic; Treatment; Renal failure; Adult; Complication; Male genital diseases
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1046/j.1523-1755.2001.00742.x

Prevalence and determinants of erectile dysfunction in hemodialysis patients.
The prevalence of erectile dysfunction (ED) among patients with end-stage renal disease (ESRD) is not known.
A cross-sectional study was conducted to determine the prevalence of ED among a community-based hemodialysis (HD) population using a two-stage cluster random sampling design. The presence and severity of ED were assessed among 302 ESRD patients using the self-administered International Index of Erectile Function-5 (IIEF-5). Logistic regression was used to examine and test associations between ED and other medical conditions.
The prevalence of any level of ED was 82% (95% CI, 76 to 87%) for all HD subjects. The prevalence of severe ED was 45% (CI, 36 to 55%). Subjects younger than 50 years had a prevalence of ED of 63% (CI, 53 to 71%), while in subjects 50 years or older, it was 90% (CI, 84 to 94%). A multivariable analysis demonstrated increasing age (50 to 59, OR = 2.04, 95% CI, 1.3 to 3.1; 60 to 69, OR = 5.5, 95% CI, 1.9 to 15.6) and diabetes (OR = 2.0, 95% CI, 1.2 to 3.3) to be independently associated with the presence of any level of ED. However, neither the subjects' age nor history of diabetes predicted the severity of ED among subjects with ED. The use of angiotensin-converting enzyme inhibitors (ACEIs) was inversely associated with ED (OR = 0.41, 95% CI, 0.17 to 0.98). Poor functional status (Karnofsky score or the Index of Physical Impairment) was not associated with ED.
ED is extremely prevalent among HD patients. Increasing age, diabetes, and nonuse of ACEIs were associated with higher prevalence of ED. The high prevalence of ED was seen even among patients with good functional status.