Prevalence and correlates of self-reported sexual dysfunction in CKD: a meta-analysis of observational studies.
BACKGROUND
Sexual dysfunction is an under-recognized problem in men and women with chronic kidney disease (CKD). The prevalence, correlates, and predictors of this condition in patients with CKD have not been evaluated comprehensively.


METHODS
Systematic review and meta-analysis.


METHODS
Patients treated using dialysis (dialysis patients), patients treated using transplant (transplant recipients), and patients with CKD not treated using dialysis or transplant (nondialysis nontransplant patients with CKD).


METHODS
Observational studies conducted in patients with CKD only or including a control group without CKD.


METHODS
Type of study population.


RESULTS
Sexual dysfunction in men and women with CKD using validated tools, such as the International Index of Erectile Function, the Female Sexual Function Index (FSFI), or other measures as reported by study investigators.


RESULTS
50 studies (8,343 patients) of variable size (range, 16-1,023 patients) were included in this review. Almost all studies explored sexual dysfunction in men and specifically erectile dysfunction. The summary estimate of erectile dysfunction in men with CKD was 70% (95% CI, 62%-77%; 21 studies, 4,389 patients). Differences in reported prevalence rates of erectile dysfunction between different studies were attributable primarily to age, study populations, and type of study tool used to assess the presence of erectile dysfunction. In women, the reported prevalence of sexual dysfunction was assessed in only 306 patients from 2 studies and ranged from 30%-80%. Compared with the general population, women with CKD had a significantly lower overall FSFI score (8 studies or subgroups, 407 patients; mean difference, -9.28; 95% CI, -12.92 to -5.64). Increasing age, diabetes mellitus, and depression consistently were found to correlate with sexual dysfunction in 20 individual studies of patients with CKD using different methods.


CONCLUSIONS
Suboptimal and lack of uniform assessment of outcome measures.


CONCLUSIONS
Sexual dysfunction is highly prevalent in both men and women with CKD, especially among those on dialysis. Larger studies enrolling different ethnic groups, using validated study tools, and analyzing the influence of various factors on the development of sexual dysfunction are needed.
Navaneethan
Sankar D
SD
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Vecchio
Mariacristina
M
Johnson
David W
DW
Saglimbene
Valeria
V
Graziano
Giusi
G
Pellegrini
Fabio
F
Lucisano
Giuseppe
G
Craig
Jonathan C
JC
Ruospo
Marinella
M
Gentile
Giorgio
G
Manfreda
Valeria Maria
VM
Querques
Marialuisa
M
Stroumza
Paul
P
Torok
Marietta
M
Celia
Eduardo
E
Gelfman
Ruben
R
Ferrari
Juan Nin
JN
Bednarek-Skublewska
Anna
A
Dulawa
Jan
J
Bonifati
Carmen
C
Hegbrant
Jörgen
J
Wollheim
Charlotta
C
Jannini
Emmanuele A
EA
Strippoli
Giovanni F M
GF
D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D006435:Renal Dialysis; D018570:Risk Assessment; D017678:Sex Distribution; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy