Understanding and affirming the sexual/relationship realities of end-stage renal disease patients and their significant others

Erectile dysfunction in chronic hemodialysis patients in dakar: a cross-sectional study in 2012

BACKGROUND

Patients with chronic kidney disease (CKD) experience multiple complications including erectile dysfunction (ED). It involves more than 50% of patients on dialysis or transplant. In Africa, the true extent of ED in CKD is unknown although some studies have been done in this regard.

OBJECTIVES

This study aimed to determine the prevalence and identify risk factors of ED in patients on hemodialysis.

PATIENTS AND METHODS

This cross-sectional multicenter study was conducted from January 2, 2012 through April 30, 2012 in four hemodialysis centers in Dakar. We included all patients on chronic hemodialysis who aged ≥ 18 years old and freely consented to participate in the study. Sociodemographic, clinical, and hemodialysis data were collected through a questionnaire. Erectile function was assessed by a short version of International Index of Erectile Function (IIEF-5).

RESULTS

Among a target of 80 patients, 73 met the inclusion criteria and were included in this study. Mean dialysis vintage was 27.3 months (range, 1-156). Their mean age was 53.81 ± 12.52 years, with a higher proportion of age group of 50 to 69 years old. Fifty-six patients were married (37 monogamous and 19 polygamous) and six were singles. Overall prevalence of ED was 84.9% and it was severe in 14 patients (19.2%). Hypertension and diabetes were the most frequent etiologies and antihypertensive treatment was used in 95.5%. The main factors associated with ED were age > 50 years old and polygamy.

CONCLUSIONS

ED is a common problem among patients on hemodialysis in Dakar with a high prevalence. Aging and diabetes represent most common causes. More efforts are needed for its early detection, prevention, and multidisciplinary management.

Couples coping in response to kidney disease: a developmental perspective

In this article we suggest that the treatment of patients with end-stage renal disease (ESRD) should be informed by three developmental perspectives. In addition to the changes in the progression of the illness and its treatment demands over time, clinicians should consider psychosocial changes and challenges related to the developmental life stage of the patient (e.g., retirement) and the evolution of the patient's romantic relationship along a variety of dimensions that may affect his or her ability to cope with the disease (e.g., emotional support, conflict, sexual functioning). We briefly review the existing literature in each area and argue that integrating all three perspectives will facilitate the long-term treatment success and patient's adjustment to the illness. Finally, we discuss the implications for the development of prevention and treatment interventions with patients and their spouses or partners and the importance of considering ethnic and cultural variations in treatment.