Erectile Dysfunction and Risk of End Stage Renal Disease Requiring Dialysis: A Nationwide Population-Based Study

Abstract

BackgroundPrevious studies have suggested that erectile dysfunction (ED) is an independent risk factor for macrovascular disease. Very few studies have evaluated the relationship between ED and risk of end stage renal disease (ESRD) requiring dialysis.MethodsA random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. We selected the control group by matching the subjects and controls by age, diabetes, hypertension, coronary heart disease, hyperlipidemia, area of residence, monthly income and index date. We identified 3985 patients with newly-diagnosed ED between 2000 and 2008 and compared them with a matched cohort of 23910 patients without ED. All patients were tracked from the index date to identify which patients subsequently developed a need for dialysis.ResultsThe incidence rates of dialysis in the ED cohort and comparison groups were 10.85 and 9.06 per 10000 person-years, respectively. Stratified by age, the incidence rate ratio for dialysis was greater in ED patients aged <50 years (3.16, 95% CI: 1.62–6.19, p = 0.0008) but not in aged 50–64 (0.94, 95% CI: 0.52–1.69, p = 0.8397) and those aged ≧65 (0.69, 95% CI: 0.32–1.52, p = 0.3594). After adjustment for patient characteristics and medial comorbidities, the adjusted HR for dialysis remained greater in ED patients aged <50 years (adjusted HR: 2.08, 95% CI: 1.05–4.11, p<0.05). The log-rank test revealed that ED patients <50-years-old had significantly higher cumulative incidence rates of dialysis than those without (p = 0.0004).ConclusionPatients with ED, especially younger patients, are at an increased risk for ESRD requiring dialysis later in life.

Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan

“…The incidence rate of ED was higher in TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively), or 0.09% (64 in 72,624) in the TBI subjects and 0.07% (146 in 217,872) in the non-TBI control. The incidence rate is similar to other studies using NHIRD for ED ( Kao et al, 2016 ; Shen, Weng, Wang, & Tien, 2014 ). The differences of prevalence rates among these studies might be related to the studies design.…”

Stage effect of chronic kidney disease in erectile function

“…CKD can interfere directly with erectile function by decreasing penile arterial blood flow, affecting penile venous leakage due to shunts, altering penile smooth muscle function, and causing hormonal disturbances and/or neurogenic dysfunction ( 30 ). Indirectly, CKD impairs erectile function by requiring use of medications with many side effects (including ED) or linked to diabetes mellitus and/or systemic arterial hypertension, conditions that lead to endothelium dysfunction causing CKD and ED ( 1 , 3 , 8 , 9 , 30 , 31 ).…”

Risk of Erectile Dysfunction in Transfusion-naive Thalassemia Men

“… 17 Therefore, traditional risk factors that impair the vascular system include several systemic diseases such as diabetes mellitus, hypertension, dyslipidemia, end-stage kidney disease, cirrhosis of the liver, and coronary artery disease. 18 – 20 Several studies have also indicated that ED could be an early sign of endothelial dysfunction and microvascular disease. 21 – 23 …”