The sexuality and quality of life of hemodialyzed patients--ASED multicenter study.
BACKGROUND
Chronic kidney disease (CKD) strongly affects sexual function (SF) and quality of life (QoL). The relations between CKD, SF, mental health, and QoL remain poorly understood in dialyzed patients.


OBJECTIVE
To correlate sexuality to QoL in hemodialysis patients.


METHODS
One hundred twelve patients (69 males and 43 females) aged 20-60 years at six dialysis units were interviewed, and their medical records were reinvestigated and supplemented with completed Beck's Depression Inventory, Self-Evaluation Questionnaire, Mell-Krat Scale, International Index of Erectile Function-5, Arizona Sexual Experience Scale, and health-related Quality of Life (Short Form [SF]-36) questionnaires.


METHODS
Prevalence of different levels of measurable aspects of sexual life, mental health, QoL, as well as their correlations, was assessed.


RESULTS
Only 55.4% of the patients were sexually active (79% in the age-matched general population) and 24.1% has ever before spoken to a doctor about their sexual life. The patients perceived sexual activity as important and were not satisfied with the performance. The predominant sexual dysfunctions were loss or diminished sexual needs (84.7% males and 48.8% females); in men, also erectile dysfunction (44.5%) and inhibited or lack of ejaculation (51.5%); in women, arousal dysfunction and anorgasmia (67.8% and 80.7%, respectively). The rate of depression was extremely high (80.5%). The patients self-assessed their QoL as low in both the physical and the mental health domains. Multiple regression analysis revealed that anxiety in men and depression in women independently predicted the lower quality of sexual life (P = 0.017 and 0.04, respectively). The general QoL, mental health, and physical health negatively correlated with the presence of depressive symptoms (P = 0.011, 0.013, and 0.011, respectively).


CONCLUSIONS
This pilot study is the first to present, in a multicenter design, the complex relations of sexuality and QoL in hemodialyzed patients, which are strongly underevaluated by medical professionals. It supports a thesis that sexual disability correlates with depression and anxiety, and seriously impacts the QoL in dialyzed patients.
Lew-Starowicz
Michal
M
Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland;. Electronic address: michallew-starowicz@wp.pl.
Gellert
Ryszard
R
Department of Nephrology, Medical Center for Postgraduate Education, Warsaw, Poland.
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult