Quality of Life in Peritoneal Dialysis Patients

Steele, Thomas E.; Baltimore, Diane; Finkelstein, Susan H.; Juergensen, P; Kliger, Alan S.; Finkelstein, Fredric O.

doi:10.1097/00005053-199606000-00007

Cited by 92 publications

(69 citation statements)

References 25 publications

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“…7 In the present study, a major prevalence of ED was found in patients whose etiology of CRF was diabetic nephropathy.…”

Section: Discussionsupporting

confidence: 50%

“…6 A recent study of 68 patients undergoing peritoneal dialysis continued to show similar results; 63 had severe ED complaints. 7 In the present study, the patients had an average age and duration of dialysis similar to the groups cited above. This work used the IIEF 3 on patients suffering from CRF.…”

Section: Discussionmentioning

confidence: 55%

“…The mean duration was similar for both groups (24 months vs 27 months). 7 A prospective study, however, has showed that complaints of intensification of sexual dysfunction occurred within the first 3 months of dialytic treatment, with stabilization of symptoms after this adaptation period. 10 In this study, when comparing patients who had been on dialysis for fewer than 3 months with those who had undergone treatment for more than 3 months, no difference in the ED complaints was found.…”

Section: Discussionmentioning

confidence: 99%

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Erectile dysfunction: prevalence and associated variables in patients with chronic renal failure

2002

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Patients with chronic renal failure (CRF) experience a significant decrease in quality of life, due both to the limitations imposed by the disease as well as the demands of the treatment that they receive. Some side effects of both illness and treatment contribute to increase the morbidity of these patients. Among them, erectile dysfunction (ED) is notable. One hundred and nineteen patients received clinical and laboratory evaluation. The following clinical data were observed: age, education, income, race, period of dialysis, period of complaints of ED, etiology of ED, use of erythropoietin, presence of arterial hypertension and=or diabetes mellitus, use of antihypertensive drugs, use of cigarettes, and psycho-emotional state of the patients. Assessment of complaints of ED was achieved using the International Index of Erectile Function (IIEF). The following laboratory data were analyzed: hemoglobin, hematocrit, free testosterone, gonadotrophin levels (FSH and LH), HDL-cholesterol, total cholesterol, prolactin, and parathyroid hormone. Statistical analysis of the means of continuous variables was performed through use of the Student's t-test. Analysis of significance of category variables was performed using the w 2 test. Descriptive analysis was obtained through use of the clinical and socio-demographic data. A multivariate model was created and the odds ratio calculated. The average age of the patients was 47.3 AE 15.9 y. The mean duration of erectile dysfunction complaints was 4 y. The average duration of dialysis was 66.2 AE 58.9 months. Prevalence of erectile dysfunction in this population was 57.9%. The main known etiology of chronic renal failure was glomerulonephritis. The main variables associated with erectile dysfunction were age, psycho-emotional state, and levels of HDL-cholesterol. This study showed a high prevalence of erectile dysfunction in the group of patients examined. Factors such as age, anxiety and depressive complaints, and dyslipidemy seem to play an important role in the origin of erectile dysfunction in such patients.

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“…7 In the present study, a major prevalence of ED was found in patients whose etiology of CRF was diabetic nephropathy.…”

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Erectile dysfunction: prevalence and associated variables in patients with chronic renal failure

2002

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“…A previous study by Steele et al (6) observed that only one half of patients on peritoneal dialysis not having intercourse desired to be sexually active. In the Dialysis Outcomes Practice Patterns Study, only 38% of patients with ESRD report that their sex lives are impacted by their ESRD disease, despite the low frequency of intercourse noted in patients with ESRD (5).…”

mentioning

confidence: 97%

Sexual Inactivity among Hemodialysis Patients

Finkelstein

2014

Clinical Journal of the American Society of Nephrology

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An emphasis on patient-centered care is becoming one of the dominant themes of health care reform worldwide. This emphasis involves active participation by patients (and their family/caregivers) in determining the type and standard of care that is best suited to maximize the individuals' quality of life. In this model, the goal of the health care provider is to develop collaborative structures of care that engage patients in decisions and empower them to make informed choices about their care. This goal requires that health care providers listen carefully to patients and strive to understand the patients' perspective on their illness, symptoms, life concerns, and treatment. Too often, health care providers focus on objective, easily assessed outcomes and organize therapeutic regimens around these measures. However, what problems and issues do patients want addressed? What are their concerns?The work by Mor et al.(1) in this issue of CJASN examines sexual functioning in women on hemodialysis (median age564 years) using a reasonable modification of the well validated Female Sexual Function Index (FSFI). This study is important, because few previous studies have critically examined the problem of the perception of the sexual functioning of women with ESRD. Mor et al.(1) note a low level of sexual activity among these patients (on all assessments, 81% of women reported that they were not sexually active), which has been well documented in prior studies (2). Importantly, however, Mor et al.(1) also look at the reasons for sexual inactivity and patient satisfaction with their current level of sexual functioning. The main reasons cited by patients for lack of sexual activity in this study were lack of a partner (39%) and lack of interest (43%). Actual sexual difficulties were cited by only 2% of women.The recent meta-analysis by Strippoli et al.(2) suggests that 84% of women on dialysis have sexual dysfunction. Sexual dysfunction in this study was defined as a score on the FSFI of $18. This instrument assesses sexual dysfunction by evaluating six domains of sexual functioning in 4 weeks before completion of the questionnaire: (1) desire, (2) arousal, (3) lubrication, (4) orgasm, (5) global satisfaction, and (6) pain. However, what if the patient is not engaging in sexual activity? Does lack of sexual activity define sexual dysfunction? A variety of factors can contribute to lack of sexual activity. For example, age is an important determinant of sexual activity (3). Of general medical patients, 60% of women ages 65-74 years and 85% of women ages 75-85 years report not having sexual activity in the preceding 12 months (3). The presence of a potential sexual partner has also been noted to be strongly associated with sexual activity for women with ESRD in the meta-analysis by Strippoli et al. (2). Similarly, for men with ESRD, the absence of a sexual partner is also associated with sexual dysfunction (4).However, are women on dialysis dissatisfied with their level of sexual activity (5,6)? A previous study by Steele et al...

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“…Despite elevated levels of LH, women on dialysis fail to have the luteal surge of LH that is directly related to ovulation [7][8]. Other factors that affect fertility in ESRD patients include subclinical hypothyroidism, medications, fatigue, anemia, and depression, which further results in lack of libido [9][10].…”

Section: Conceptionmentioning

confidence: 99%