title: Prevalence and determinants of erectile dysfunction in hemodialysis patients.
abstract: BACKGROUND
  The prevalence of erectile dysfunction (ED) among patients with end-stage renal disease (ESRD) is not known.
  
  
  METHODS
  A cross-sectional study was conducted to determine the prevalence of ED among a community-based hemodialysis (HD) population using a two-stage cluster random sampling design. The presence and severity of ED were assessed among 302 ESRD patients using the self-administered International Index of Erectile Function-5 (IIEF-5). Logistic regression was used to examine and test associations between ED and other medical conditions.
  
  
  RESULTS
  The prevalence of any level of ED was 82% (95% CI, 76 to 87%) for all HD subjects. The prevalence of severe ED was 45% (CI, 36 to 55%). Subjects younger than 50 years had a prevalence of ED of 63% (CI, 53 to 71%), while in subjects 50 years or older, it was 90% (CI, 84 to 94%). A multivariable analysis demonstrated increasing age (50 to 59, OR = 2.04, 95% CI, 1.3 to 3.1; 60 to 69, OR = 5.5, 95% CI, 1.9 to 15.6) and diabetes (OR = 2.0, 95% CI, 1.2 to 3.3) to be independently associated with the presence of any level of ED. However, neither the subjects' age nor history of diabetes predicted the severity of ED among subjects with ED. The use of angiotensin-converting enzyme inhibitors (ACEIs) was inversely associated with ED (OR = 0.41, 95% CI, 0.17 to 0.98). Poor functional status (Karnofsky score or the Index of Physical Impairment) was not associated with ED.
  
  
  CONCLUSIONS
  ED is extremely prevalent among HD patients. Increasing age, diabetes, and nonuse of ACEIs were associated with higher prevalence of ED. The high prevalence of ED was seen even among patients with good functional status.
authors.affiliation: Renal-Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Rosas
authors.forename: M
authors.initials: M
authors.lastname: Joffe
authors.forename: E
authors.initials: E
authors.lastname: Franklin
authors.forename: B L
authors.initials: BL
authors.lastname: Strom
authors.forename: W
authors.initials: W
authors.lastname: Kotzker
authors.forename: C
authors.initials: C
authors.lastname: Brensinger
authors.forename: E
authors.initials: E
authors.lastname: Grossman
authors.forename: D
authors.initials: D
authors.lastname: Glasser
authors.forename: H I
authors.initials: HI
authors.lastname: Feldman
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D006977:Hypertension, Renal / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011788:Quality of Life; D006435:Renal Dialysis; D012307:Risk Factors