Evaluation of relationship between sexual functions, depression and quality of life in patients with chronic kidney disease at predialysis stage

Abstract

Aim: The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage. Patients and methods: Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yılmaz Education and Research Hospital, were enrolled. Age-and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed. Findings: Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p ¼ 0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p ¼ 0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p40.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p ¼ 0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p ¼ 0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p ¼ 0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p ¼ 0.0001). Conclusion: We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.

Association between Sex Hormone and Blood Uric Acid in Male Patients with Type 2 Diabetes

“…The present study investigated 205 male patients with diabetes, of which 70 (34.2%) patients had TT levels < 12 nmol/L. Among healthy male individuals, the reported percentage of individuals with sexual dysfunction varies between 20 and 80% [ 19 – 21 ]. In an Australian cross-sectional study of 1089 patients with type 2 diabetes, 36.5% patients had hypogonadism [ 10 ].…”

Discussing Sexual Dysfunction with Chronic Kidney Disease Patients: Practice Patterns in the Office of the Nephrologist

“…Nevertheless, effects of a decreased QoL due to SD on the course of CKD should not be underestimated. SD is a serious problem in all stages of CKD: predialysis, dialysis, and after renal transplantation [8,33,34].…”

<p>The Effect of Peer Support on Hope Among Patients Under Hemodialysis</p>

“…14 Hope can be a therapeutic, multi-dimensional, dynamic, and powerful factor, playing an important role in coping with disabilities. 15 Different studies have shown a positive association between hope and positive emotions 16 and self-respect. 17 Additionally, negative associations have been revealed between hope and exhaustion 18 and negative emotions.…”