Is dialysis adequacy a useful predictor for sexual function in males and females with end-stage renal disease?

Introduction

The development of sexual dysfunction (SD) in dialysis patients is multifactorial. We aimed to evaluate whether adequate dialysis had an effect on the development of SD in male and female patients undergoing dialysis due to end stage renal disease. Anxiety, depression, health-related quality of life and the other risk factors related to dialysis were also evaluated in terms of SD.

Methods

Seventy men and 57 women undergoing haemodialysis (HD) or peritoneal dialysis (PD) and 65 healthy male volunteers and 48 healthy female volunteers, age-matched, were included in the study. The International Index of Erectile Function, Female Sexual Function Index, Beck Depression Inventory, Beck Anxiety Inventory and The Short Form-36 Health Survey were applied to all participants. The cut off value of Kt/V was determined as 1.3 for HD and 1.7 for PD to assess dialysis adequacy. Per gender, all the participants were divided into three groups as control, adequate dialysis and non-adequate dialysis.

Results

Dialysis adequacy [OR: 3.225, 95%CI (1.213–8.620), p = .019] was found as a more decisive factor for male SD, while dialysis adequacy [OR: 3.015, 95%CI (.991–7.250), p = .041] and depression [OR: 4.280, 95%CI (1.705–10.747), p = .002] were more significant for female SD. In addition, a strong relationship was found between male SD and physical functioning (r: .524, p = .032), social functioning (r: .565, p = .042), general health (r: .693, p = .037) perception, while female SD was found to be strongly associated with anxiety (r: −.697, p = .002) and depression (r: −.738, p = .001).

Discussion

Dialysis adequacy was found to be the most important factor in reducing SD. Non-adequate dialysis resulted in worse sexual function, higher levels of depression and anxiety. Its negative effect on health-related quality of life was only seen in men.