The Impact of Erectile Dysfunction on the Quality of Life of Men Undergoing Hemodialysis and Its Association with Depression

Abstract

Introduction Erectile dysfunction (ED) is highly prevalent among men undergoing hemodialysis. Aim This study was performed to identify the influence of ED on the patient’s quality of life (QoL) and to evaluate the influence of depression on erectile function of these patients. Main Outcome Measures For this multicenter cross-sectional study, 275 patients were interviewed through questionnaires: the five-item version of the International Index of Erectile Function was used for diagnosing and classifying ED; the Medical Outcomes Study Questionnaire 36-Item Short Form Health Survey (SF-36) for scoring QoL; and the Hospital Anxiety and Depression Scale (HADS) to evaluate depressive symptoms. Linear regression was used to examine the associations between some of the variables and ED. Predialytic biochemical and hematological parameters were determined during the longer interdialytic period. Results Patients had a mean age of 48.6 ± 12.8 years, and the ED prevalence was 72.3%. Advanced age, diabetes and depression score were independent risk factors for the development of ED as confirmed by linear regression (P <0.001, P = 0.002, and P <0.001, respectively). QoL was worse among patients with any degree of ED, and the scores were statistically significant for overall health rating (P = 0.016), physical composite score (P = 0.003), bodily pain (P = 0.042), physical functioning (P <0.001), and vitality (P = 0.005). Furthermore, more severe forms of ED were associated with a lower QoL. After adjustment for some variables, such as age, time under dialysis, hemoglobin, albumin, parathyroid hormone, Kt/V, and depression, linear regression showed that domains related to poorer physical functioning (P = 0.047) and decreased vitality (P = 0.009) were significantly related to ED. Conclusion Depression is an important trigger for the development of ED in hemodialysis patients, and this sexual condition is an independent risk factor for their poor QoL.

Symptoms and quality of life from patients undergoing hemodialysis in Switzerland

“…This result is in line with other studies that found sex-related symptoms to be a major issue for HD patients [45] regardless of cultural differences. [46] Despite the solid literature on the subject, until recently sex-related symptoms have remained in the shadows because patients considered them part of the natural aging process [47] and healthcare professionals tended to underestimate them on account of their "non-lethal nature". [47,48] Moreover, both healthcare professionals and patients are at times embarrassed to talk about these issues [47] despite the desire for information and, if needed, treatment.…”

“…[46] Despite the solid literature on the subject, until recently sex-related symptoms have remained in the shadows because patients considered them part of the natural aging process [47] and healthcare professionals tended to underestimate them on account of their "non-lethal nature". [47,48] Moreover, both healthcare professionals and patients are at times embarrassed to talk about these issues [47] despite the desire for information and, if needed, treatment. The literature suggests that the taboo surrounding sexual practices, in general, and patient sexuality, in particular, are still problematic issues for both healthcare professionals and researchers.…”

Lifestyle and metabolic approaches to maximizing erectile and vascular health

“…58 The lower incidence of ED in renal transplant patients compared to men having dialysis suggests that metabolic factors may play a role in the ED of men with chronic kidney disease. 59 Decreased quality of life is strongly correlated with ED in men having dialysis, 60 emphasizing that more attention should be paid to treating ED in these men.…”

The efficacy of udenafil in end-stage renal disease patients undergoing hemodialysis

“…24,25 However, in HD patients studies report very high rates of ED of 71-80%. [1][2][3][4][5][6] Compared to non-uremic patients, the high rate of ED in HD patients has been identified as having organic and psychogenic causes. The successful treatment of ED in HD patients increases the quality of life and reduces psychometric factors in the ED etiology.…”

“…Studies have shown that the prevalence of ED is 71-80% in HD patients. [1][2][3][4][5][6] It has been found that organic and psychogenic factors are involved in severe increases in ED in HD patients compared to non-uremic patients. [7][8][9] In HD patients, there are increases in testicular failure, secondary disturbances in the pituitary-gonadal axis, plasma estrogen, and prolactin levels identified in the early period.…”