Priapism and dialysis.
Ninety-three dialysis units located in the tri-state area were surveyed for the prevalence of priapism. Seventeen of 3,337 male patients experienced an episode of priapism. All of these episodes occurred either during or 2-7 h after dialysis, suggesting a cause-and-effect relationship. The use of heparin during dialysis seemed to play a role in its induction; none of the patients on peritoneal dialysis experienced priapism, and heparin was not used in their exchanges. Eleven of 17 patients also received androgen therapy which might have been a contributing factor. Additional considerations included dialysis-induced hypoxemia and acidosis which have been known to precipitate priapism in patients with sickle cell disease or trait. In our study, 2 of 10 patients, including our case report, were black males with sickle cell trait. The calculated prevalence in the male population is 1:196, and in blacks and Caucasians 1:128 and 1:293, respectively. Except for 2 cases of sickle cell trait in the 10 black males, no particular subpopulation at risk was identified. In view of the absence of a proven etiologic agent and the relatively low prevalence of priapism we do not recommend changes in dialysate, anticoagulant, or the use of androgen therapy.
D000328:Adult; D003237:Connecticut; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D009518:New York; D010530:Peritoneal Dialysis; D011317:Priapism / Q000453:epidemiology / Q000209:etiology*; D006435:Renal Dialysis / Q000009:adverse effects*; D012306:Risk