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Fujita N, Momota M, Ishida M, Iwane T, Hatakeyama S, Yoneyama T, Hashimoto Y, Yoshikawa K, Yamaya K, Ohyama C. Association of oxidative stress with erectile dysfunction in community-dwelling men and men on dialysis. Aging Male 2022; 25:193-201. [PMID: 35916472 DOI: 10.1080/13685538.2022.2103113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To investigate the association between oxidative stress and erectile dysfunction (ED) in community-dwelling men and men on dialysis. METHODS This cross-sectional study included 398 community-dwelling men and 42 men on dialysis. Oxidative stress was assessed using 8-hydroxy-2'-deoxyguanosine (8-OHdG). Univariable and multivariable logistic regression analyses were performed to evaluate the association between oxidative stress and ED. RESULTS Spearman's rank correlation test showed no significant correlation between urine 8-OHdG levels and the 5-Item International Index of Erectile Function scores in community-dwelling men (ρ = -0.005, p = 0.917) and between plasma 8-OHdG levels and the Sexual Health Inventory for Men scores in men on dialysis (ρ = 0.166, p = 0.295). In community-dwelling men, univariable and multivariable analyses revealed that urine 8-OHdG level was not significantly associated with ED (odds ratio [OR]: 1.005, 95% confidence interval [CI]: 0.884-1.144, p = 0.934; OR: 0.930, 95% CI: 0.798-1.084, p = 0.353; respectively). In men on dialysis, univariable analyses revealed that plasma 8-OHdG level was not significantly associated with severe ED (OR: 0.967, 95% CI: 0.876-1.066, p = 0.498). CONCLUSIONS Oxidative stress was not significantly associated with ED prevalence and severity in community-dwelling men and men on dialysis.
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Affiliation(s)
- Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masaki Momota
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Mizuri Ishida
- Department of Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takuro Iwane
- Department of Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Kanemitsu Yamaya
- Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Muacevic A, Adler JR. Sexual Dysfunction in Female Patients Undergoing Hemodialysis and Its Relationship With Anxiety and Depression. Cureus 2022; 14:e29883. [PMID: 36348849 PMCID: PMC9629872 DOI: 10.7759/cureus.29883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Hemodialysis is renal replacement therapy. However, it is associated with various complications. Sexual dysfunction is one of them. It is estimated that 25%-64% of female patients on hemodialysis have sexual dysfunction worldwide. This impaired quality of life further leads to anxiety and depression. Around 22.8%-39.3% of patients on hemodialysis are depressed while 27% have a major anxiety disorder. In Pakistan, the incidence of end-stage renal disease (ESRD) is 100 per million people. As far as we know, this is the first study conducted in Multan to assess sexual dysfunction in female patients undergoing hemodialysis. The objective of this study was to find out the prevalence of sexual dysfunction in female patients on hemodialysis and its relationship with anxiety and depression. Material and methods A cross-sectional study was conducted in Nishtar Medical University Hospital, Multan, Pakistan, from February 2021 to May 2021. Data were collected from 55 female patients in the form of an interview after having met inclusion and exclusion criteria. The questionnaire had some sociodemographic questions. The female sexual function index (FSFI) was used to evaluate sexual dysfunction in hemodialysis patients while anxiety and depression were assessed using the hospital anxiety and depression (HADS) scale. SPSS version 25.0 (IBM Corp., Armonk, NY) was used for data analysis. Pearson's correlation was used to find the association of sexual dysfunction with anxiety and depression. A p-value of <0.05 was considered statistically significant. Results Hypertension (56.4%) was the leading cause of chronic kidney disease (CKD). The most serious problem of the patients was sexual arousal suggested by the low mean score (1.77 ± 2.27) as compared to other sexual domains. Anxiety and depression were found in 20% and 30.9% of patients, respectively. There was a significant negative correlation between age ((arousal: r= -0.297, p= 0.028), (lubrication: r= -0.274, p= 0.043), (orgasm: r= -0.298, p= 0.027), and (pain: r= -0.271, p= 0.045)) and depression ((desire: r= -0.465, p= <0.001), (satisfaction: r= -0.366, p= 0.006)) with sexual function. While anxiety was not significantly associated with sexual function ((desire: r= -0.347, p= 0.069), (arousal: r= 0.053, p= 0.700), (lubrication: r= 0.061, p= 0.658), (orgasm: r= 0.047, p= 0.736), (satisfaction: r= -0.113, p= 0.410) and (pain: r= 0.045, p= 0.746)). Conclusion Sexual dysfunction is not uncommon in female hemodialysis patients. There was a significant negative correlation of different sexual domains with age and depression, respectively. The correlation of anxiety with sexual dysfunction was found to be statistically insignificant.
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Duru H. The prevalence and severity of mental health problems and sexual dysfunction in hemodialysis patients before and during the COVID-19 pandemic. Ther Apher Dial 2022; 26:1211-1219. [PMID: 35088541 DOI: 10.1111/1744-9987.13805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study aimed to investigate the prevalence and severity of mental health problems and sexual dysfunction in hemodialysis patients before and during the COVID-19 pandemic. METHODS A total of 84 hemodialysis patients were evaluated in terms of Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), International Index of Erectile Function (IIEF-5) and Female Sexual Function Index (FSFI). RESULTS Poor sleep quality (79.8%) and poor mental health status (62.7%) and higher likelihood of having depression (31.0 vs. 61.9%, p < 0.001) were noted. The IIEF-5 (10.5(5-25) vs. 7.5(5-23), p < 0.001) and FSFI (12(4-78) vs. 6(4-66), p < 0.001) scores were significantly decreased during the pandemic with an increase in the likelihood of having erectile dysfunction (p < 0.001). CONCLUSION Our findings indicate high prevalence of mental health issues, an impaired quality of life and an increase in prevalence and severity of suspected depression during pandemic in hemodialysis patients along with deterioration in erectile dysfunction among males.
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Affiliation(s)
- Huseyin Duru
- Department of Internal Medicine, Rize State Hospital, Rize, Turkey
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4
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Duarsa GWK, Kandarini Y, Winarta GK, Santosa KB, Yudiana IW, Tirtayasa PMW, Pramana IBP, Oka AAG, Pradhana AP. A Comparison of Erectile Dysfunction Improvement Between Patients With Regular Hemodialysis and Patients With Continuous Ambulatory Peritoneal Dialysis. J Sex Med 2021; 18:920-925. [PMID: 33814356 DOI: 10.1016/j.jsxm.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is one of the sexual dysfunctions that are often encountered as a complication of male patients with stage 5 chronic kidney disease (stage 5 CKD). ED can be caused by psychological factors in patients with regular dialysis therapy. Currently, Hemodialysis (HD) therapy is the first choice in dialysis therapy and only 2% of stage 5 CKD patients are using Continuous Ambulatory Peritoneal Dialysis (CAPD) as a dialysis therapy. ED in stage 5 CKD patients should become a part of the treatment of patients with dialysis, which hopefully will improve the quality of life of patients. This study aims to compare the improvement in ED degree in patients with HD and CAPD. METHOD This study is an observational analytic comparative study involving 44 male patients with stage 5 CKD; 22 of whom underwent HD and the remaining 22 patients underwent CAPD. The differences evaluated were changes in the ED degree before and after dialysis, which were assessed using the International Index of Erectile Function-5 (IIEF-5). RESULT There were significant differences in the improvement in ED degree and IIEF-5 scores in CAPD group. In the HD group, no significant difference was obtained in the improvement in ED degree and IIEF-5 score. A significant difference was obtained in the improvement in ED degree between the HD and CAPD groups by comparing the improvement in IIEF-5 score. CONCLUSION Patients with CAPD have a better improvement in ED degree than patients with HD. Duarsa GWK, Kandarini Y, Winarta GK, et al. A Comparison of Erectile Dysfunction Improvement Between Patients With Regular Hemodialysis and Patients With Continuous Ambulatory Peritoneal Dialysis. J Sex Med Rev 2021;18:920-925.
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Affiliation(s)
- Gede Wirya Kusuma Duarsa
- Urology Division, General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - Yenny Kandarini
- Nephrology Division, Internal Medicine Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - Gede Kesuma Winarta
- General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - Kadek Budi Santosa
- Urology Division, General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - I Wayan Yudiana
- Urology Division, General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | | | - Ida Bagus Putra Pramana
- Urology Division, General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - Anak Agung Gde Oka
- Urology Division, General Surgery Department, Faculty of Medicine, Udayana University, Bali - Indonesia
| | - Adinda Putra Pradhana
- Anesthesiology and Intensive Care Department, Faculty of Medicine, Udayana University, Bali - Indonesia.
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Kang J, Tian J, Lu Y, Song Y, Liu X. Erectile function after kidney transplantation: a meta-analysis. Transl Androl Urol 2020; 9:1967-1979. [PMID: 33209661 PMCID: PMC7658109 DOI: 10.21037/tau-20-604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Erectile dysfunction (ED) is common in patients with end-stage renal disease (ESRD). Whether kidney transplantation can improve erectile function in patients with ESRD is still controversial. We conducted a meta-analysis on the relationship between kidney transplantation and erectile function. Methods A literature search was conducted on PubMed, Embase, Cochrane Library, and Web of Science until May 31, 2019. Primary outcomes were ED prevalence and each domain score of the International Index of Erectile Function (IIEF) questionnaire. We used age-matched dialysis patients or patients before kidney transplantation as a control group and compared them to kidney transplant recipients. Results A total of 9 articles were finally enrolled in the study. Compared with the control group, the kidney transplantation group had a lower prevalence of ED (OR 0.49, 95% CI: 0.28–0.86) and higher domain scores for erectile function (SMD 0.53, 95% CI: 0.12–0.94) and sexual desire (SMD 1.19, 95% CI: 0.11–2.27). While there were no significant variations in domain scores for orgasmic function (SMD 0.27, 95% CI: −0.10–0.63), intercourse satisfaction (SMD 0.26, 95% CI: −0.10–0.61), and overall satisfaction (SMD 0.17, 95% CI: −0.21–0.56). Patients in the kidney transplantation group had higher serum testosterone (SMD 1.20, 95% CI: 0.86–1.54) and lower prolactin (SMD −1.46, 95% CI: −2.22 to −0.69) and luteinizing hormone (SMD −0.97, 95% CI: −1.39 to −0.55). Conclusions Kidney transplantation may be associated with improved erectile function in patients with ESRD. This may be attributable to the correction of endocrine hormone disorders in patients after kidney transplantation.
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Affiliation(s)
- Jiaqi Kang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jia Tian
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Lu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Stolic RV, Bukumiric Z, Belic B, Odalovic B, Relic G, Sovtic S, Sipic M, Mitrovic V, Krdzic B. Survival of Patients on Hemodialysis with Erectile Dysfunction. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E500. [PMID: 32987816 PMCID: PMC7598609 DOI: 10.3390/medicina56100500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 01/14/2023]
Abstract
Background and objectives: In patients on hemodialysis, erectile dysfunction is an independent mortality factor. This study aimed to determine the risk factors that affect the survival of hemodialysis patients with erectile dysfunction. Materials and Methods: During a seven-year period, erectile dysfunction was identified among the fatalities reported in patients receiving chronic hemodialysis, on the basis of the International Index of Erectile Function questionnaire. The study covered 70 patients of mean age 57 ± 6.7 years. During the examined period, 42 (60%) patients died at the mean age 57 ± 6.8 years. The study was completed by 28 (40%) patients, aged 57 ± 6.55 years. Laboratory, demographic, anthropometric, and clinical characteristics were recorded using standard methods. Results: Statistically significant differences between the two groups of respondents were found concerning dialysis duration (p < 0.001), number of leukocytes (p = 0.003), adequacy of hemodialysis (p = 0.004), intima media thickness of the carotid artery (p < 0.001), presence of cardiovascular disease (p = 0.03), residual diuresis (p = 0.04), and hemodiafiltration (p < 0.001). Hemodialysis adequacy (B = -9.634; p = 0.017), intima media thickness (B = 0.022; p = 0.003), residual diuresis (B = -0.060; p = 0.007), and lower rates of cardiovascular disease (B = 0.176; p = 0.034) were significant survival predictors among our patients with erectile dysfunction. Conclusions: Risk factors that are associated with improved survival of patients on hemodialysis with erectile dysfunction in our study are: preserved diuresis, high-quality hemodialysis, lower incidence of cardiovascular disease, and less thickening of the intima media of the carotid arteries.
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Affiliation(s)
- Radojica V. Stolic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Zoran Bukumiric
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Branislav Belic
- Department of Otorhinolaryngology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Bozidar Odalovic
- Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, 38210 K. Mitrovica, Serbia; (B.O.); (G.R.); (S.S.); (M.S.); (B.K.)
| | - Goran Relic
- Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, 38210 K. Mitrovica, Serbia; (B.O.); (G.R.); (S.S.); (M.S.); (B.K.)
| | - Sasa Sovtic
- Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, 38210 K. Mitrovica, Serbia; (B.O.); (G.R.); (S.S.); (M.S.); (B.K.)
| | - Maja Sipic
- Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, 38210 K. Mitrovica, Serbia; (B.O.); (G.R.); (S.S.); (M.S.); (B.K.)
| | - Vekoslav Mitrovic
- Faculty of Medicine Foca, University of East Sarajevo, 71123 Lukavica, Bosnia and Herzegovina;
| | - Biljana Krdzic
- Faculty of Medicine Pristina/K. Mitrovica, University of Pristina/K. Mitrovica, 38210 K. Mitrovica, Serbia; (B.O.); (G.R.); (S.S.); (M.S.); (B.K.)
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7
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Jalón Monzón A, Álvarez Múgica M, Gorostidi Pérez M, Escaf Barmadah S. [Sexual disorders in the renal patient]. Semergen 2018; 45:63-72. [PMID: 30482490 DOI: 10.1016/j.semerg.2018.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 01/23/2023]
Abstract
Quality of Life Related to Health is currently considered one of the primary therapeutic objectives in renal failure patients who need substitution treatment as life prolonging therapy. Sexual health is a basic right that positively affects the quality of life. Although a significant percentage of chronic patients have some type of sexual dysfunction, this is not openly discussed, making it important for doctors to address these issues in the clinic. A review is presented on the pathophysiology of sexual dysfunctions in both male and female chronic renal patients. The effects of dialysis and transplantation on sexual function will be addressed, as well as presenting the main sexual dysfunctions and their treatment.
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Affiliation(s)
- A Jalón Monzón
- Unidad de Gestión Clínica de Urología, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España.
| | - M Álvarez Múgica
- Servicio de Urología, Hospital Valle del Nalón, Langreo, Asturias, España
| | - M Gorostidi Pérez
- Unidad de Gestión Clínica de Nefrología, HUCA, Oviedo, Asturias, España
| | - S Escaf Barmadah
- Unidad de Gestión Clínica de Urología, HUCA, Oviedo, Asturias, España
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Cohen C, Antonini M, Delmas P. Évidence d’un manque de concordance entre les patients hémodialysés et les infirmières sur la présence et la sévérité des symptômes. Rech Soins Infirm 2018:7-19. [DOI: 10.3917/rsi.132.0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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9
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Razdan S, Greer AB, Patel A, Alameddine M, Jue JS, Ramasamy R. Effect of prescription medications on erectile dysfunction. Postgrad Med J 2017; 94:171-178. [PMID: 29103015 DOI: 10.1136/postgradmedj-2017-135233] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 10/23/2017] [Indexed: 11/04/2022]
Abstract
Erectile dysfunction (ED) affects about 50% of men in the USA and is primarily attributed to physiological (organic) and psychological causes. However, a substantial portion of men suffer from ED due to iatrogenic causes. Common medications such as antihypertensives, non-steroidal anti-inflammatory drugs and antacids may cause ED. Physicians should be aware of the various prescription medications that may cause ED to properly screen and counsel patients on an issue that many may feel too uncomfortable to discuss. In this review, we discuss the physiology, data and alternative therapies for the ED caused by medications.
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Affiliation(s)
- Shirin Razdan
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Aubrey B Greer
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Amir Patel
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mahmoud Alameddine
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Joshua S Jue
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Nishida H, Yamagishi A, Sakurai T, Shibasaki T, Kawazoe H, Ichiyanagi O, Kato T, Nagaoka A, Tomita Y, Tsuchiya N. Risk factors for erectile dysfunction in end-stage renal disease patients with short- or long-term hemodialysis therapy. RENAL REPLACEMENT THERAPY 2016. [DOI: 10.1186/s41100-016-0079-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Savadi H, Khaki M, Javnbakht M, Pourrafiee H. The Impact of Hemodialysis on Sexual Function in Male Patients using the International Index of Erectile Function Questionnaire (IIEF). Electron Physician 2016; 8:2371-7. [PMID: 27382447 PMCID: PMC4930257 DOI: 10.19082/2371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/06/2016] [Indexed: 01/30/2023] Open
Abstract
Introduction Routine hemodialysis is one of the preferred treatment methods in patients with chronic kidney disease. It seems that routine hemodialysis can be effective in improving sexual function in these patients. This study aimed to determine the effect of routine dialysis sessions over a six-month period on the status of sexual function in men with chronic renal failure using the International Index of Erectile Function (IIEF) questionnaire. Methods The cross-sectional study was conducted from November 2015 to November 2016 on patients with chronic renal failure who were first-time candidates for routine hemodialysis and who were referred to Imam Reza Hospital of Mashhad. All of the patients completed the IIEF questionnaire before their first hemodialysis. Afterwards, all of the patients underwent routine dialysis sessions over a six-month period and completed the IIEF questionnaire again at the end of the sixth month. The prevalence of sexual dysfunction was assessed before and after hemodialysis. The scores on the two IIEF questionnaires were compared according to five domains, i.e., erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. The comparisons were done before and after hemodialysis using the paired-samples t-test. Statistical analyses were performed using SPSS version 19. Results The study included 30 men with a mean age of 40.2 ± 8.2. The prevalence of sexual dysfunctions in the order of their frequency was as follows: intercourse satisfaction (100%), overall satisfaction (100%), sexual desire (96.7%), orgasmic function (93.3%), and erectile function (90%). After six months of treatment with hemodialysis, the ratings of all areas of sexual dysfunction were improved significantly (p-value = 0.00 for all domains). Conclusion According to the results of this study, it seems that a six-month course of hemodialysis can improve erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction in patients with chronic kidney disease.
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Affiliation(s)
- Hossein Savadi
- M.D, Department of Medicine, Mashhad Medical Science Branch, Islamic Azad University, Mashhad, Iran
| | - Morteza Khaki
- Internist, Department of Internal Medicine, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Javnbakht
- Psychiatrist, Department of Psychiatry, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Hasan Pourrafiee
- Internist, Department of Internal Medicine, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
As medical advances are made in the care of persons with chronic illnesses including those with end-stage renal disease (ESRD), patients are not only experiencing increasing life expectancy but also bearing the burden of illness and treatment for a longer duration of time. With this in mind, it is increasingly important for health care providers to pay close attention to their individual patient's perceptions of their health, fitness, life satisfaction, and well-being. This assessment of Health-Related Quality of Life (HRQOL) also includes an evaluation of the patient's level of satisfaction with treatment, outcome, and health status, also taking into account their perspective on future prospects. In addition to improving patient-provider communication by helping in the identification and prioritization of problems, it is important to note that high HRQOL has been shown to be associated with better medical outcomes, including reduction in hospitalizations and death. In this review, we outline several validated tools that are used to quantitatively measure HRQOL in the ESRD population and incorporate these instruments in a review of specific, evidence-based measures by which we can measurably improve health-related quality of life in dialysis patients.
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Affiliation(s)
- Donald Mitema
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Bernard G Jaar
- Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Nephrology Center of Maryland, Baltimore, Maryland
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13
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Dhindsa S, Reddy A, Karam JS, Bilkis S, Chaurasia A, Mehta A, Raja KP, Batra M, Dandona P. Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease. Eur J Endocrinol 2015; 173:359-66. [PMID: 26101371 DOI: 10.1530/eje-15-0359] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/22/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND One-third of men with type 2 diabetes have subnormal testosterone concentrations along with inappropriately normal LH and FSH concentrations. It is not known if the presence of renal insufficiency affects free testosterone concentrations in men with type 2 diabetes. HYPOTHESIS We hypothesized that type 2 diabetic men with chronic renal disease (CKD; estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m(2)) have lower free testosterone concentrations than men with normal renal function (eGFR ≥ 60 ml/min per 1.73 m(2)). STUDY DESIGN AND SETTING This is a retrospective chart review of patients attending diabetes and nephrology clinics. Men with type 2 diabetes who had the following information available were included in the study: testosterone (total and free) done by LC/MS-MS followed by equilibrium dialysis, sex hormone binding globulin, LH, FSH and prolactin concentrations. PARTICIPANTS We present data on T and gonadotropin concentrations in 111 men with type 2 diabetes and CKD (stages 3-5) and 182 type 2 diabetic men without CKD. RESULTS The prevalence of subnormal free testosterone concentrations was higher in men with type 2 diabetes and CKD as compared to those without CKD (66% vs 37%, P < 0.001). Men with CKD had a higher prevalence of hypergonadotropic hypogonadism (26% vs 5%, P < 0.001) but not of hypogonadotropic hypogonadism (HH; 40% vs 32%, P = 0.22). There was an increase in the prevalence of hypergonadotropic hypogonadism with decreasing eGFR. Fifty-two percent of men with renal failure (CKD stage 5) had hypergonadotropic hypogonadism and 25% had HH. In men with CKD, the hemoglobin concentrations were lower in those with subnormal free T concentrations as compared to men with normal free T concentrations (119 ± 19 vs 128 ± 19 g/l, P = 0.04). CONCLUSIONS Two-thirds of men with type 2 diabetes and CKD have subnormal free T concentrations. The hypogonadism associated with CKD is predominantly hypergonadotropic.
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Affiliation(s)
- Sandeep Dhindsa
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Anand Reddy
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Jyotheen Sukhmoy Karam
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Sayeeda Bilkis
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Archana Chaurasia
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Aditya Mehta
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Keerthi P Raja
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Manav Batra
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
| | - Paresh Dandona
- Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA
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Abstract
The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.
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15
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Shaban H, Ubaid-Ullah M, Berns JS. Measuring Vitamin, Mineral, and Trace Element Levels in Dialysis Patients. Semin Dial 2014; 27:582-6. [DOI: 10.1111/sdi.12260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Hesham Shaban
- Department of Medicine; Perelman School of Medicine at the University of Pennsylvania; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
| | - Muhammad Ubaid-Ullah
- Department of Medicine; Perelman School of Medicine at the University of Pennsylvania; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
| | - Jeffrey S. Berns
- Department of Medicine; Perelman School of Medicine at the University of Pennsylvania; Hospital of the University of Pennsylvania; Philadelphia Pennsylvania
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