title: The impact of erectile dysfunction on the quality of life of men undergoing hemodialysis and its association with depression.
abstract: BACKGROUND
  Erectile dysfunction (ED) is highly prevalent among men undergoing hemodialysis.
  
  
  OBJECTIVE
  This study was performed to identify the influence of ED on the patient's quality of life (QoL) and to evaluate the influence of depression on erectile function of these patients.
  
  
  METHODS
  For this multicenter cross-sectional study, 275 patients were interviewed through questionnaires: the five-item version of the International Index of Erectile Function was used for diagnosing and classifying ED; the Medical Outcomes Study Questionnaire 36-Item Short Form Health Survey (SF-36) for scoring QoL; and the Hospital Anxiety and Depression Scale (HADS) to evaluate depressive symptoms. Linear regression was used to examine the associations between some of the variables and ED. Predialytic biochemical and hematological parameters were determined during the longer interdialytic period.
  
  
  RESULTS
  Patients had a mean age of 48.6 ± 12.8 years, and the ED prevalence was 72.3%. Advanced age, diabetes and depression score were independent risk factors for the development of ED as confirmed by linear regression (P < 0.001, P = 0.002, and P < 0.001, respectively). QoL was worse among patients with any degree of ED, and the scores were statistically significant for overall health rating (P = 0.016), physical composite score (P = 0.003), bodily pain (P = 0.042), physical functioning (P < 0.001), and vitality (P = 0.005). Furthermore, more severe forms of ED were associated with a lower QoL. After adjustment for some variables, such as age, time under dialysis, hemoglobin, albumin, parathyroid hormone, Kt/V, and depression, linear regression showed that domains related to poorer physical functioning (P = 0.047) and decreased vitality (P = 0.009) were significantly related to ED.
  
  
  CONCLUSIONS
  Depression is an important trigger for the development of ED in hemodialysis patients, and this sexual condition is an independent risk factor for their poor QoL.
authors.affiliation: Department of Urology, State University of Pernambuco, Recife, Brazil.
authors.forename: Gisele Vajgel
authors.initials: GV
authors.lastname: Fernandes
authors.forename: Rondineli Roberto
authors.initials: RR
authors.lastname: dos Santos
authors.forename: Waldênio
authors.initials: W
authors.lastname: Soares
authors.forename: Louize Gomes
authors.initials: LG
authors.lastname: de Lima
authors.forename: Breno Santiago
authors.initials: BS
authors.lastname: de Macêdo
authors.forename: João Eduardo
authors.initials: JE
authors.lastname: da Fonte
authors.forename: Bruno Silva Peixoto
authors.initials: BS
authors.lastname: de Carvalho
authors.forename: Sandra Neiva
authors.initials: SN
authors.lastname: Coelho
authors.forename: Adriano Almeida
authors.initials: AA
authors.lastname: Calado
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D012307:Risk Factors; D012720:Severity of Illness Index