Intima‐media thickness of carotid arteries and erectile dysfunction in hemodialysis patients

Abstract

The prevalence of erectile dysfunction (ED) in hemodialysis (HD) is extremely high. The objective of this study was to evaluate the association between the intima-media thickness of carotid arteries and ED in HD patients. The survey was organized as a cross-sectional study in men aged up to 65 years, in the HD. All respondents voluntarily completed the questionnaire of the International Index of Erectile Function-5, adjusted for the Serbian language, verified routine laboratory analysis, calculated body mass index, demographic structure, duration of dialysis, the presence of hepatotropic viruses and erythropoietin therapy, smoking and drinking alcohol, determined the quality of HD, verified significantly comorbidities and measured the intima-media thickness of carotid artery using the Doppler method. The prevalence of ED in our study was 82.2%. Erectile dysfunction significantly more prevalent in older (P = 0.001) and obese patients (P = 0.047). It is significantly represented in patients with cardiovascular disease (P = 0.006), in those who consume alcohol (P = 0.04) and patients with higher values of intima-media thickness of carotid arteries (P = 0.007). Spearman's coefficient of linear correlation (ρ=-0.34, P=0.006) and linear regression (b=-2.02, P<0.001) indicated a negative association between intima-media thickness and the International Index of Erectile Function score. The prevalence of ED in our patients was 82.2%, more common in older and obese patients, a significant determinant of alcohol consumption and cardiovascular disease. Increased thickness of the intima media of the carotid arteries was associated with a higher incidence of ED.

Associated factors and prevalence of erectile dysfunction in hemodialysis patients

“…No association of ED and PTH in HD patients has been verified in the present work and others (9,11,19). However, Rosas et al (10) (2001) found lower levels of PTH associated with ED only on unadjusted analysis for confounding factors.…”

“…This occurred because smoking causes vasoconstriction in the penile venous plexus and thereby affects contraction of cavernous smooth muscle, which has a negative effect on EF (26). Despite this, other studies did not find this association (8,13,15,16,19). Association between ED and smoking habits (previous or current) not independent of other factors was found in this work.…”

“…Despite this, the NIH Consensus Development Panel on Impotence (18) (1993) concluded that since other risk factors for ED appear with aging, ED could not be considered a direct result of aging. One of these age-related risk factors is the presence of atherosclerosis, which is also a known risk factor for ED (19). Atherosclerosis is responsible for the abnormal function and responsiveness of penile vasculature, and it can also contribute to the pathogenesis of ED (16).…”

“…There is an association of ED and cardiovascular diseases (19). Endothelium dysfunction occurs in cardiovascular diseases and it may contribute to the pathogenesis of ED (25).…”

Male Sexual Dysfunction and Chronic Kidney Disease

“…Indeed, an association has been shown between severe ED and coronary artery calcium score in dialysis patients (29) and between ED and carotid intima-media thickness in hemodialysis recipients (30). …”