[Sexual function and quality of life in hemodialysis male patients].
BACKGROUND
The sexual dysfunction is a highly prevalent problem among uremic men that limits their quality of life. The aim of this study was to determine the sexual function in chronic renal failure in males patients on hemodialysis and to find the nature of the problem. Also, we explored the impact of sexual dysfunction on health-related quality of life.


METHODS
103 male patients older than 18 years and receiving HD treatment were studied. The sexual function was evaluated with the International Index of Erectile Function, and the health-related quality of life was quantified with the COOP-WONCA Charts, both in their Spanish versions.


RESULTS
47% of the patients didn't have any kind of sexual activity. These ones presented a more advanced age (p < 0.001), a longer stay on dialysis (p < 0.001), a greater comorbidity index (p < 0.05) and smaller levels of seric albumin (p < 0.05). The sexually active patients presented a better physical fitness (p < 0.001) and overall health (p < 0.05), and a smaller difficulty to carry out the daily activities (p < 0.05) and pain (p < 0.05). A 40% of the patients with some kind of sexual function had a good erectile function, the 34.5% suffered a slight erectile dysfunction, the 16.4% a moderate one and the 9.1% a severe one. Multiple linear regression analysis demonstrated that the main determinant of the sexual activity was the age, followed by the physical fitness and the time on HD (32.7% of the variance explained). We found statistically significative correlation between the total score of IIEF and felings (r = -0.34; p < 0.05), daily activities (r = -0.27; p < 0.05), social activities (r = -0.30; p < 0.05), social support (r = -0.45; p < 0.01) and quality of life (r = -0.29; p < 0.05). The patients without sexual activity didn't perceive their deficiency as a problem and considered this situation inherent to the ageing process.


CONCLUSIONS
The sexual dysfunction is a highly prevalent problem in the uremic male, but it doesn't have to be necessarily associated to a serious deterioration of the HRQOL. In this way, the presence or not of sexual activity doesn't present significant effect on the things that one has or wants to do. With everything, the patient without sexual activity frequently has advanced age, refers worse state of health and presents more problems of physical functioning and at the moment of taking to daily activities.
Martín-Díaz
F
F
Servicio de Nefrología Sanatorio Perpetuo Socorro, Alicante, Universidad de Alicante.
Reig-Ferrer
A
A
Ferrer-Cascales
R
R
D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D019529:Sexuality