Prevalence and correlates of erectile dysfunction in men on chronic haemodialysis: a multinational cross-sectional study.
BACKGROUND
Factors associated with erectile dysfunction in men on haemodialysis are incompletely identified due to suboptimal existing studies. We determined the prevalence and correlates of erectile dysfunction and identified combinations of clinical characteristics associated with a higher risk of erectile dysfunction using recursive partitioning and amalgamation (REPCAM) analysis.


METHODS
We conducted a multinational cross-sectional study in men on haemodialysis within a collaborative network. Erectile dysfunction and depressive symptoms were evaluated using the erectile function domain of the International Index of Erectile Function questionnaire and the Center for Epidemiological Studies-Depression Scale, respectively.


RESULTS
Nine hundred and forty-six (59%) of 1611 eligible men provided complete data for erectile dysfunction. Eighty-three per cent reported erectile dysfunction and 47% reported severe erectile dysfunction. Four per cent of those with erectile dysfunction were receiving pharmacological treatment. Depressive symptoms were the strongest correlate of erectile dysfunction [adjusted odds ratio 2.41 (95% confidence interval (CI) 1.57-3.71)]. Erectile dysfunction was also associated with age (1.06, 1.05-1.08), being unemployed (1.80, 1.17-2.79) or receiving a pension (2.05, 1.14-3.69) and interdialytic weight gain (1.9-2.87 kg, 1.92 [CI 1.19-3.09]; >2.87 kg, 1.57 [CI 1.00-2.45]). Married men had a lower risk of erectile dysfunction (0.49, 0.31-0.76). The prevalence of erectile dysfunction was highest (94%) in unmarried and unemployed or retired men who have depressive symptoms.


CONCLUSIONS
Most men on haemodialysis experience erectile dysfunction and are untreated. Given the prevalence of this condition and the relative lack of efficacy data for pharmacological agents, we suggest that large trials of pharmacological and non-pharmacological interventions for erectile dysfunction and depression are needed.
Mariacristina
M
Vecchio
Suetonia
S
Palmer
Giorgia
G
De Berardis
Jonathan
J
Craig
David
D
Johnson
Fabio
F
Pellegrini
Antonio
A
Nicolucci
Michela
M
Sciancalepore
Valeria
V
Saglimbene
Letizia
L
Gargano
Carmen
C
Bonifati
Marinella
M
Ruospo
Sankar D
SD
Navaneethan
Vincenzo
V
Montinaro
Paul
P
Stroumza
Marianna
M
Zsom
Mariatta
M
Torok
Eduardo
E
Celia
Ruben
R
Gelfman
Anna
A
Bednarek-Skublewska
Jan
J
Dulawa
Giusi
G
Graziano
Giuseppe
G
Lucisano
Giorgio
G
Gentile
Juan Nin
JN
Ferrari
Antonio
A
Santoro
Annalisa
A
Zucchelli
Giorgio
G
Triolo
Stefano
S
Maffei
Jörgen
J
Hegbrant
Charlotta
C
Wollheim
Salvatore
S
De Cosmo
Valeria M
VM
Manfreda
Giovanni F M
GF
Strippoli
D000368:Aged; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007390:International Agencies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D011795:Surveys and Questionnaires