The association of glomerular filtration rate and erectile dysfunction with severity of coronary artery disease in patients presenting with chest pain

Solak, Yalçın; Akıllı, Hakan; Atalay, Hüseyin; Kayrak, Mehmet; Gök, Hasan; Türk, Süleyman

doi:10.1007/s11255-009-9694-y

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Adult male patients with ED and chest pain, presumably of coronary origin, had a worse GFR ( 24 ). As the severity of the ED increased, a more severe decrease in the creatinine clearance occurred in male subjects with chest pain ( 25 ). Observational research involving 270 consecutive hypertensive male patients showed a significant correlation between the ED score and GFR ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Stage effect of chronic kidney disease in erectile function

Costa

Ponciano

Costa³

et al. 2018

Int. braz j urol.

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PurposeThe study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction.Materials and MethodsThis transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient.ResultsTwo hundred and forty five patients with chronic kidney disease in conservative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction.ConclusionsThe study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages) worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression.

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Section: Discussionmentioning

confidence: 99%

Stage effect of chronic kidney disease in erectile function

Costa

Ponciano

Costa³

et al. 2018

Int. braz j urol.

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“…This was a cross‐sectional study, and the participants were recruited from a prospectively maintained cohort. Previously we reported that reduced estimated glomerular filtration rate (eGFR), and presence and severity of ED were associated with severity of CAD in this cohort [31]. We included 312 consecutive adult male patients who for the first time presenting with chest pain to our cardiology outpatient clinic.…”

Section: Methodsmentioning

confidence: 99%

Uric Acid Level and Erectile Dysfunction in Patients with Coronary Artery Disease

Solak¹,

Akıllı

Kayrak

et al. 2014

The Journal of Sexual Medicine

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Introduction Erectile dysfunction (ED) is a frequent complaint of elderly subjects, and is closely associated with endothelial dysfunction and cardiovascular disease. Uric acid is also associated with endothelial dysfunction, oxidative stress and cardiovascular disease, raising the hypothesis that an increased serum uric acid might predict erectile dysfunction in patients who are at risk for coronary artery disease. Aim To evaluate the association of serum uric acid levels with presence and severity of ED in patients presenting with chest pain of presumed cardiac origin. Methods This is a cross-sectional study of 312 adult male patients with suspected coronary artery disease who underwent exercise stress test (EST) for workup of chest pain and completed a sexual health inventory for men (SHIM) survey form to determine the presence and severity of ED. Routine serum biochemistry (and uric acid levels) were measured. Logistic regression analysis was used to assess risk factors for ED. Main Outcome Measures The short version of the international index of erectile function (IIEF-5) questionnaire diagnosed ED (cutoff score ≤21). Serum Uric acid levels were determined. Patients with chest pain of suspected cardiac origin underwent an exercise stress test. Results 149 of 312 (47.7%) male subjects had ED by survey criteria. Patients with ED were older and had more frequent CAD, hypertension, diabetes, and impaired renal function, and also had significantly higher levels of uric acid, fibrinogen, glucose, CRP, triglycerides compared with patients without ED. Uric acid levels were associated with ED by univariate analysis (OR = 1.36, p = 0.002); however, this association was not observed in multivariate analysis adjusted for eGFR. Conclusion Subjects presenting with chest pain of presumed cardiac origin are more likely to have ED if they have elevated uric acid levels.

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“…Clinically and experimentally, accelerated pathogenic vascular adaptations have been linked to a decline in erectile function [13,34,35]. In CKD patients, both the degree of CAD [36] and severity of coronary artery calcification [37] have been associated with ED. While the bilateral internal pudendal artery (IPA) is the dominant controller of total penile vascular resistance (∼70%) [38], its susceptibility to vascular calcification in CKD is not well established.…”

Section: Introductionmentioning

confidence: 99%

Calcification of the Internal Pudendal Artery and Development of Erectile Dysfunction in Adenine-Induced Chronic Kidney Disease: A Sentinel of Systemic Vascular Changes

Maio¹,

McCabe²,

Pruss³

et al. 2014

The Journal of Sexual Medicine

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Introduction Chronic kidney disease (CKD), erectile dysfunction (ED), and cardiovascular disease share common vascular etiologies and risk factors. Aim Using a rat model, this is the first study to characterize the consequences of CKD in the onset and development of ED associated with differential regional vascular calcification and circulatory changes. Methods Stable CKD was generated at 3 weeks in male Sprague-Dawley rats given dietary adenine and progressed until 7 weeks. Mineral content and morphometry were assessed in the internal pudendal arteries (IPAs), thoracic aorta, and carotid artery. Endothelial function was determined via changes in serum von Willebrand factor (VWF) and endothelium-dependent relaxation of the thoracic aorta. Results In severe CKD rats, calcium and phosphate content in all arteries increased, and pulse wave velocity was elevated. Distal IPA segments, in particular, were the first to calcify, but penile tissue per se did not. CKD rats had endothelial dysfunction, as indicated by a decrease in acetylcholine-mediated relaxation (∼40%) and an increase in serum VWF (∼40%), as well as increased lumen diameter (20%) of the distal IPA. Erectile function, assessed using a centrally acting dopaminergic agent, was significantly impaired by 7 weeks (∼40%). Conclusions In CKD, the distal IPA appears to be more susceptible to vascular dysfunction and calcification. Additionally, the onset of ED may be an important sentinel of impending systemic vascular disease. To confirm this concept, future experimental and clinical studies will need to examine a range of vessel types and the use of supplementary methods to assess erectile function.

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The association of glomerular filtration rate and erectile dysfunction with severity of coronary artery disease in patients presenting with chest pain

Abstract: The presence and severity of ED and reduced eGFR are associated with the severity of underlying CAD in patients presenting with chest pain, and they could be implemented in the risk stratification of these patients.

Cited by 5 publications

References 23 publications

Stage effect of chronic kidney disease in erectile function

Stage effect of chronic kidney disease in erectile function

Uric Acid Level and Erectile Dysfunction in Patients with Coronary Artery Disease

Calcification of the Internal Pudendal Artery and Development of Erectile Dysfunction in Adenine-Induced Chronic Kidney Disease: A Sentinel of Systemic Vascular Changes

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