Prevalence and associated risk factors of male erectile dysfunction among patients on hemodialysis and kidney transplant recipients: A cross-sectional survey from Sudan

Abstract

Male erectile dysfunction (ED) is an important issue worldwide occurring in 5-69% of men in community-based studies. It is more common in patients with chronic kidney disease (CKD) and those on peritoneal as well as hemodialysis (HD), occurring in more than 80% of patients. In Sudan, there is no previous report on ED among patients with CKD. A cross-sectional study was done to determine the prevalence of ED and its associated risk factors among Sudanese CKD patients on HD and those who underwent renal transplant. This was conducted in Khartoum, Sudan from October 2005 to July 2006 including all married men who were on maintenance HD for more than three months and all married men who had received renal transplantation at least three months earlier. Single, divorced/separated men, those whose wives were living away, those who were bed-bound and those with cognitive impairment were also excluded. After obtaining consent for participation, demographic and clinical data were collected by using anonymous questionnaires and the Arabic version of International Index of Erectile Function (IIEF; the Egyptian version). Patients who did not participate in full and proper manner were considered as "non-responders." A total of 146 patients, 106 HD patients, and 40 renal transplant recipients completed the IIEF questionnaire. Non-responders constituted 43.7% and 54.5% of HD and transplant recipient patients, respectively. Blood samples were taken after completion of the IIEF questionnaire to determine the required investigations. ED prevalence was high among our study patients, 83% among the HD patients and 67.5% among the renal transplant recipients. Univariate analysis showed that there was a trend, although non-significant, of older age being associated with ED in both groups. Similar association was seen in those who were under-dialyzed in the HD group and DM in the transplant recipient group. Previous history of ED was significantly associated with current presence of ED in both groups. More studies with larger sample size are needed to clarify the results of this study.

Vitamin D Status in Renal Transplant recipients is not Associated with Erectile Dysfunction

“…Out of 40 study patients, only 10 (25%) had no ED (ED 0 group), 20 patients had mild (ED 1) and seven patients mild to moderate ED (ED 2), while three patients had severe ED (ED 4 group). Th e high presence of ED among our renal transplant recipients is in line with earlier reports of 42% to 78% prevalence in this population 12,[24][25][26][27] . Th e levels of 25(OH)D and PTH, as well as other study parameters on both measurements did not diff er among ED groups.…”

The Impact of Hemodialysis on Sexual Function in Male Patients using the International Index of Erectile Function Questionnaire (IIEF)

“…Given all the above, and taking sexual activities into account as a factor influencing the quality of life, study in this field is justified to improve the conditions of patients with chronic kidney disease. In Mekki et al, a study in Sudan, the prevalence of ED was reported to be 83% among HD patients ( 13 ). In Makarem et al’s study in Iran, the prevalence of ED in patients on HD was reported to be 86.6% ( 18 ).…”

“…This is probably because of fewer complications and fewer debilitating diseases ( 9 , 34 ). With an increase in age, the incidence of sexual dysfunction also increases ( 11 , 13 , 35 ). The quality of sexual function before the study can impact the results of such studies.…”

“…Based on different definitions and methods in previous studies, the prevalence of ED in patients with CRF has been reported in the range of 22–88% ( 3 , 5 – 12 ). In various studies, this rate has been reported as 82.7% in patients with CRF who had been dialyzed recently ( 13 ), 51.9–88% in patients on peritoneal dialysis ( 14 , 15 ), and about 87.5% in patients on hemodialysis (HD) ( 16 , 17 ). To date, in four valid studies that we were able to identify in Iran, 86.6–100% of patients on HD have had sexual dysfunction ( 10 , 16 – 18 ).…”

Hyperbranched polyglycerol is superior to glucose for long-term preservation of peritoneal membrane in a rat model of chronic peritoneal dialysis

“…However, increasing evidence in the literature clearly demonstrates that the long-term exposure to these glucose-containing PD solutions is associated with systemic health complications (e.g. an increase in cardiovascular disease and the loss of residual kidney function) in PD patients particularly for those with diabetes [6–10], and causes local deleterious effect on the peritoneum—leading to ultrafiltration failure (UFF) and resulting in poor outcome of PD [11, 12]. Thus, there is an unmet need for glucose-free PD solutions in order to improve clinical outcomes of PD.…”