Correlation Evaluation of Sexuality Disorders with Serum Prolactin, Adequacy of Dialysis, and Some Laboratory Findings in Hemodialysis Patients

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Nephrology, School of Medicine AND Department of Internal Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Associate Professor, Department of Urology, School of Medicine AND Department of Surgery, Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 General Practitioner, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Associate Professor, Department of Biostaticstics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: Sexuality disorders and infertility are common in hemodialysis patients and may be due to hormonal disorders, uremic milieu, drugs effect and psychological problems. The aim of this study was the evaluation of association between sexuality disorders and some demographic and laboratory indices in hemodialysis patients.Methods: In a cross-sectional study, 60 male hemodialysis patients in Chahar Mahal va Bakhtiari Province, southwest of Iran, were studied. Demographic criteria including age, blood pressure, and laboratory findings such as before and after dialysis serum blood urea nitrogen (BUN), parathyroid hormone (PTH), Ca, P, K, prolactin, Fe, total iron binding capacity (TIBC), and ferritin levels and dialysis efficacy index (Clearance multiplied by time/volume or Kt/V) were obtained for all participants. Sexually function was evaluated using International index of erectile function-15 (IIEF-15) check-list.Findings: Mean age of the patients was 58.9 ± 19.9 years. The patients had significant disorders in all aspects of sexually functions including erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction (P < 0.05 for all). Sexually function decreased significantly with increasing age. Serum PTH level was inversely correlated with erectile function and overall sexual satisfaction. Post dialysis BUN was associated with orgasmic dysfunction and intercourse satisfaction problem. In addition, pre-dialysis systolic blood pressure was inversely correlated with orgasmic function and overall intercourse satisfaction.Conclusion: Our findings showed that in hemodialysis patients, control of hyperparathyroidism and blood pressure, and increasing of dialysis efficacy may lead to improvement of sexually function in hemodialysis patients.

Keywords


  1. Toorians AW, Janssen E, Laan E, Gooren LJ, Giltay EJ, Oe PL, et al. Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response. Nephrol Dial Transplant 1997; 12(12): 2654-63.
  2. Arslan D, Aslan G, Sifil A, Cavdar C, Celebi I, Gamsari T, et al. Sexual dysfunction in male patients on hemodialysis: assessment with the International Index of Erectile Function (IIEF). Int J Impot Res 2002; 14(6): 539-42.
  3. Diemont WL, Vruggink PA, Meuleman EJ, Doesburg WH, Lemmens WA, Berden JH. Sexual dysfunction after renal replacement therapy. Am J Kidney Dis 2000; 35(5): 845-51.
  4. Handelsman DJ. Hypothalamic-pituitary gonadal dysfunction in renal failure, dialysis and renal transplantation. Endocr Rev 1985; 6(2): 151-82.
  5. Rosas SE, Wasserstein A, Kobrin S, Feldman HI. Preliminary observations of sildenafil treatment for erectile dysfunction in dialysis patients. Am J Kidney Dis 2001; 37(1): 134-7.
  6. Carrero JJ, Qureshi AR, Parini P, Arver S, Lindholm B, Barany P, et al. Low serum testosterone increases mortality risk among male dialysis patients. J Am Soc Nephrol 2009; 20(3): 613-20.
  7. Handelsman DJ, Dong Q. Hypothalamo-pituitary gonadal axis in chronic renal failure. Endocrinol Metab Clin North Am 1993; 22(1): 145-61.
  8. Blumberg A, Wildbolz A, Descoeudres C, Hennes U, Dambacher MA, Fischer JA, et al. Influence of 1,25 dihydroxycholecalciferol on sexual dysfunction and related endocrine parameters in patiens on maintenance hemodialysis. Clin Nephrol 1980; 13(5): 208-14.
  9. Allaf ME, Hoke A, Burnett AL. Erythropoietin promotes the recovery of erectile function following cavernous nerve injury. J Urol 2005; 174(5): 2060-4.
  10. Lawrence IG, Price DE, Howlett TA, Harris KP, Feehally J, Walls J. Correcting impotence in the male dialysis patient: experience with testosterone replacement and vacuum tumescence therapy. Am J Kidney Dis 1998; 31(2): 313-9.
  11. Rodger RS, Fletcher K, Dewar JH, Genner D, McHugh M, Wilkinson R, et al. Prevalence and pathogenesis of impotence in one hundred uremic men. Uremia Invest 1984; 8(2): 89-96.
  12. Glass CA, Fielding DM, Evans C, Ashcroft JB. Factors related to sexual functioning in male patients undergoing hemodialysis and with kidney transplants. Arch Sex Behav 1987; 16(3): 189-207.
  13. Stewart M. Narrative literature review: sexual dysfunction in the patient on hemodialysis. Nephrol Nurs J 2006; 33(6): 631-41.
  14. Hou SH, Grossman S, Molitch ME. Hyperprolactinemia in patients with renal insufficiency and chronic renal failure requiring hemodialysis or chronic ambulatory peritoneal dialysis. Am J Kidney Dis 1985; 6(4): 245-9.
  15. Newton SE. Sexual dysfunction in men on chronic hemodialysis: a rehabilitation nursing concern. Rehabil Nurs 1999; 24(1): 24-9.
  16. Burnett AL. The role of nitric oxide in erectile dysfunction: implications for medical therapy. J Clin Hypertens (Greenwich ) 2006; 8(12 Suppl 4): 53-62.
  17. Chou FF, Lee CH, Shu K, Yu TJ, Hsu KT, Sheen-Chen SM. Improvement of sexual function in male patients after parathyroidectomy for secondary hyperparathyroidism. J Am Coll Surg 2001; 193(5): 486-92.
  18. Makarem AR, Karami MY, Zekavat OR. Erectile dysfunction among hemodialysis patients. Int Urol Nephrol 2011; 43(1): 117-23.
  19. Malekmakan L, Shakeri S, Haghpanah S, Pakfetrat M, Sarvestani AS, Malekmakan A. Epidemiology of erectile dysfunction in hemodialysis patients using IIEF questionnaire. Saudi J Kidney Dis Transpl 2011; 22(2): 232-6.
  20. Johannes CB, Araujo AB, Feldman HA, Derby CA, Kleinman KP, McKinlay JB. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol 2000; 163(2): 460-3.
  21. Kerr DN. Hypercalcemia and metastatic calcification. Cardiovasc Res 1997; 36(3): 293-7.
  22. Sahovic V, Sahovic S, Grosa E, Avdic E, Helac-Cvijetic D, Kukavica N. Correlation between parathormone and sexual hormones in patients on haemodialysis. Med Arh 2012; 66(3): 177-80.
  23. Fabre LF, Clayton AH, Smith LC, Goldstein IM, Derogatis LR. Association of major depression with sexual dysfunction in men. J Neuropsychiatry Clin Neurosci 2013; 25(4): 308-18.
  24. Dusing R. Sexual dysfunction in male patients with hypertension: influence of antihypertensive drugs. Drugs 2005; 65(6): 773-86.
  25. Ferrario CM, Levy P. Sexual dysfunction in patients with hypertension: implications for therapy. J Clin Hypertens (Greenwich ) 2002; 4(6): 424-32.
  26. Palmer BF. Sexual dysfunction in uremia. J Am Soc Nephrol 1999; 10(6): 1381-8.
  27. Anantharaman P, Schmidt RJ. Sexual function in chronic kidney disease. Adv Chronic Kidney Dis 2007; 14(2): 119-25.