Male sexual dysfunction in patients with chronic end-stage renal insufficiency and in renal transplant recipients

Materials and Methods: The study wasconducted from December 2011 toDecember 2012 on 95 patients between the ages of 20 and65 years: 44 of which had been undergoing dialysis for overa year and 51 of whom had undergone kidney transplantsmore than 6 months before. Comorbidities were carefullyrecorded, erectile function was evaluated the with IIEF5questionnaire and serum levels of total testosterone / freeand prolactin were tested at early morning (7 AM). Toassess the relationship between erectile dysfunction (ED)and clinical laboratory tests, Student's t-test statistical(quantitative variables), chi-square (qualitative variables),the uni and multivariate analysis were used.Results: In patients undergoing dialysis and in recentlytransplanted patients a higher instance of ED was found(70% and 65% of cases respectively). Amongst dialyzedpatients, patients aged over 50 suffer from ED more fre-quently. Patients aged over 50s represent 61% of the totalnumber of patients suffering from ED, and just 31% ofpatients not suffering from ED, (p = 0.006);Hyperprolactinemia was found in 23% and 20% of bothgroups respectively. Fifty nine % of the dialyzed patientspresented values of testosterone serum levels of less than250 ng/dl with a significant difference between those whowere suffering from ED and those who were not (65% of EDpatients vs. 46%,of patients not affected from ED p = 0.019).This was found in only 37% of transplanted patients andthere does not appear to be a statistically significant correla-tion with the onset of ED (p = 0.12). In patients over the ageof 50, diabetes and a condition of hypotestosteronemia weresignificantly correlated with ED at univariate and multivari-ate analyses. Conclusions: The ED in patients with end stage chronic kid-ney failure (CKF) continues to have a strong prevalence,either in the patients who are undergoing dialysis or in thosewho have received transplants. In literature this issue is notsufficiently considered if not at all. Hypotestosteronemia is arisk factor for the onset of ED in end stage CKF patients. Asignificantly lower prevalence of hypogonadism among dia-lyzed patents and transplant recipients suggests that renaltransplantation may be protective for the sexual capabilitiesof these patients.