title: Association of decreased quality of life and erectile dysfunction in hemodialysis patients.
abstract: BACKGROUND
  Quality of life in hemodialysis patients has been associated with treatment outcomes. We explored the impact of erectile dysfunction on quality of life in a cohort of hemodialysis subjects.
  
  
  METHODS
  A random sample of 302 Philadelphia area hemodialysis (HD) subjects was enrolled using a cross-sectional design. Subjects completed a self-administered questionnaire including items on sexual function, past medical history, and quality of life. Linear regression (accounting for sampling design by weighted estimation methods) was used to examine the associations between various measures of quality of life (the dependent variables) and erectile dysfunction (ED) and other variables (the predictor variables).
  
  
  RESULTS
  We found the emotional domains of the SF-36, a multi-purpose, short-form health survey with 36 questions, to be more profoundly associated with ED than the physical domains. Using the physical and mental components of the SF-12, a new 12-item short form health survey as predictors of ED, only the mental composite score (MCS) was statistically significant after adjusting for age and diabetes (P = 0.008). Subjects with ED had significantly lower quality of life mean scores. In particular, ED was associated with poorer social interaction (mean score difference, -10.3, adjusted P < 0.001), decreased emotional well-being (-12.9, adjusted P = 0.005), more role limitations due to emotional problems (-22.9, adjusted P = 0.01), and poorer social function (-17.8, P = 0.001).
  
  
  CONCLUSIONS
  Recent advances in therapies for ED warrant that the diagnosis and treatment of erectile dysfunction be included in the global health assessment by the nephrologists and primary care providers of patients with renal insufficiency, as it may improve the quality of life of patients.
authors.affiliation: Renal, Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. sylvia.rosas@uphs.upenn.edu
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Rosas
authors.forename: Marshall
authors.initials: M
authors.lastname: Joffe
authors.forename: Eunice
authors.initials: E
authors.lastname: Franklin
authors.forename: Brian L
authors.initials: BL
authors.lastname: Strom
authors.forename: Wayne
authors.initials: W
authors.lastname: Kotzker
authors.forename: Colleen
authors.initials: C
authors.lastname: Brensinger
authors.forename: Eric
authors.initials: E
authors.lastname: Grossman
authors.forename: Dale B
authors.initials: DB
authors.lastname: Glasser
authors.forename: Harold I
authors.initials: HI
authors.lastname: Feldman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D004644:Emotions; D007172:Erectile Dysfunction / Q000503:physiopathology* / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D019964:Mood Disorders / Q000209:etiology / Q000523:psychology; D011788:Quality of Life; D006435:Renal Dialysis; D012380:Role