title: Evaluation of relationship between sexual functions, depression and quality of life in patients with chronic kidney disease at predialysis stage.
abstract: OBJECTIVE
  The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage.
  
  
  METHODS
  Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yılmaz Education and Research Hospital, were enrolled. Age- and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed.
  
  
  RESULTS
  Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p=0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p=0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p>0.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p=0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p=0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p=0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p=0.0001).
  
  
  CONCLUSIONS
  We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Research and Training Center , Istanbul , Turkey .
authors.forename: Bennur
authors.initials: B
authors.lastname: Esen
authors.forename: Serdar
authors.initials: S
authors.lastname: Kahvecioglu
authors.forename: Ahmet Engin
authors.initials: AE
authors.lastname: Atay
authors.forename: Gulten
authors.initials: G
authors.lastname: Ozgen
authors.forename: Muhammed Masuk
authors.initials: MM
authors.lastname: Okumus
authors.forename: Nurhan
authors.initials: N
authors.lastname: Seyahi
authors.forename: Dede
authors.initials: D
authors.lastname: Sit
authors.forename: Pınar
authors.initials: P
authors.lastname: Kadioglu
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008487:Medical History Taking / Q000379:methods; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012107:Research Design; D012720:Severity of Illness Index; D012737:Sex Factors; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology; D012735:Sexual Dysfunction, Physiological / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D014421:Turkey / Q000453:epidemiology
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Chronic kidney disease; depression; life quality; predialysis stage; sexual dysfunction