Sexual function in chronic kidney disease.
Endocrine abnormalities are common in patients with chronic kidney disease (CKD) and lead to sexual dysfunction, anemia, hyperparathyroidism, and altered mineral metabolism. Common clinical problems include disturbances in menstruation in women, erectile dysfunction in men, and decreased libido and infertility in both sexes. Organic factors tend to be prominent and are related to uremia and other comorbid illnesses. Psychological factors and depression may exacerbate the primary problem. Alterations in the hypothalamic-pituitary axis are seen early in CKD and tend to worsen after patients start dialysis. Hypogonadism plays a dominant role in male sexual function, whereas changes in hypothalamic-pituitary function predominate in female sexual dysfunction. In patients on dialysis, treatment strategies include optimizing dose of dialysis, correction of anemia with erythropoietin, and correction of hyperparathyroidism. Successful kidney transplantation may restore normal sexual function, especially in younger patients.
Anantharaman
Priya
P
West Virginia University School of Medicine, Morgantown, WV 26505, USA.
Schmidt
Rebecca J
RJ
D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects; D002908:Chronic Disease; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000150:complications; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D011687:Purines / Q000627:therapeutic use; D011994:Recombinant Proteins; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects / Q000172:deficiency
D000728:Androgens; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D011994:Recombinant Proteins; D013450:Sulfones; D004921:Erythropoietin; D013739:Testosterone; D000068677:Sildenafil Citrate