Sexual dysfunction common but rarely studied in CKD patients
9/2/2010
The majority of adult dialysis patients suffer from some form of sexual dysfunction, according to a systematic review published online Sept. 1, 2010 in the American Journal of Kidney Diseases. Analyzing 50 studies and 8,343 patients, the review found that 70% of men with chronic kidney disease had erectile dysfunction, while 30%-80% of women with CKD reported symptoms of sexual dysfunction.
“It is surprising how few studies have evaluated the prevalence and predictors of such an important and relevant condition,” said senior author Giovanni Strippoli. “Clinicians are well aware that sexual dysfunction is a frequently reported problem,” but he said that in clinical care and grant-funded research, other medical conditions tend to take precedence. An emphasis on survival may downplay attention given to sexual dysfunction.
The authors found many studies were hampered by low response rates, study heterogeneity, and the use of non-validated instruments. In addition, studies focused on women are almost non-existent, with the current review finding only 2 studies meeting their criteria. “Current data remain suboptimal,” Strippoli said, “and there is an unmet need for good prognosis and intervention studies in this area.”
Despite the limitations of the literature, the authors report that there are a number of take-home messages for clinicians. Of the 70% of CKD patients with erectile dysfunction, only 17% characterize their symptoms as mild, and nearly one quarter qualify as having severe dysfunction. Hemodialysis and peritoneal dialysis patients had a higher prevalence of reporting sexual dysfunction than patients who had received a transplant. Increasing age, diabetes, and depression consistently correlated with sexual dysfunction in 20 studies. Less than 5% of the patients in the studies included in the systematic review were non-dialysis, non-transplant CKD patients.
http://www.nephronline.com/news.asp?N_ID=4070
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