The connection between erectile dysfunction (ED) and other health conditions demonstrates the importance of understanding the mechanisms of sexual dysfunction. ED and chronic kidney disease (CKD) are closely linked, with approximately 80% of CKD patients also afflicted by ED.1 These conditions are frequently diagnosed together because they share neurological and hormonal pathophysiological mechanisms as well as multiple risk factors.2
CKD is a prevalent, irreversible condition that currently affects 13.1% of U.S. adults, and the number of diagnoses is increasing.3 Because CKD can remain asymptomatic until later stages of the disease, early detection is crucial in order to preserve renal function.4
Recent research has indicated that ED is not only a symptom of CKD, but a contributing factor as well.5 A study evaluating the role of sexual dysfunction in kidney disease concluded that ED increased the risk for end stage renal disease and subsequent dialysis treatment.6
A 2021 study discovered that ED-related disruptions in endothelial functioning created the vascular conditions necessary for CKD and renal failure.7 Endothelial damage impairs the release of nitrous oxide, which can increase capillary pressure and vascular resistance in the glomerulus.8 Furthermore, changes in the hypothalamic-pituitary-gonadal axis consistent with CKD are also responsible for the reduced testosterone levels seen in ED.9
Sexual dysfunction and kidney disease share multiple risk factors, namely, diabetes, hypertension, cardiovascular disease, hyperparathyroidism, dyslipidemia, and depression.10 Because ED and CKD are linked both directly and indirectly, physicians must closely monitor their patients for sexual dysfunction, as it could be an indicator of a more serious condition.
The clinical relationship between sexual dysfunction and kidney disease highlights the importance of diagnosing ED early. ED is both under-diagnosed and under-treated in CKD patients, so it is imperative that doctors understand the causal relationship between these two conditions.11 ED is often left untreated because of a lack of awareness, cost of treatment, and feelings of embarrassment.12 Furthermore, advancements in CKD treatments have substantially improved life expectancy, and preserving sexual function is an important part of maintaining quality of life.13
- Suzuki, E., Nishimatsu, H., Oba, s., Takahashi, M., Homma, Y. (2014). Chronic kidney disease and erectile dysfunction. World Journal of Nephrology 3(4), 220-229.
- Edey, M.M. (2017). Male Sexual Dysfunction and Chronic Kidney Disease. Frontiers in Medicine 4(32).
- Ammirati, A.L. (2020). Chronic kidney disease. Rev Assoc Med Bras 66(1).
- Gaitonde, D.Y., Cook, D.L., Rivera, I.M. (2017). Chronic Kidney Disease: Detection and Evaluation. American Family Physician 96(12), 776-783.
- Costa, M.R., Ponciano, V.C., Costa, T.R., Gomes, C.P., de Oliveira, E.C. (2018). Stage effect of chronic kidney disease in erectile function. International Brazilian Journal of Urology 44(1), 132-140.
- Shen, Y.C., Weng, S.F., Wang, J.J., Tien, K..J. (2014). Erectile Dysfunction and Risk of End Stage Renal Disease Requiring Dialysis: A Nationwide Population-Based Study. PLOS ONE 9(7), e102055.
- Cirakoglu, A., Yuce, A., Benli, E., Arici, Y.K., Dugeroglu, H., Ogreden, E. (2021). Is erectile dysfunction an early clinical symptom of chronic kidney disease? The Aging Male 24(1), 24-28.
- Ayub, W. & Fletcher, S. End-stage renal disease and erectile dysfunction. Is there any hope? Nephrology Dialysis Transplantation 15(10), 1525-1528.
- Holley, J.L. (2004). The hypothalamic-pituitary axis in men and women with chronic kidney disease. Advances in Chronic Kidney Disease 11(4), P337-P341.
- Fiuk, J.V. & Tadros, N.N. (2019). Erectile dysfunction in renal failure and transplant patients. Translational Andrology and Urology 8(2), 155-163.
- Papadopoulou, E., Varouktsi, A., Lazaridis, A., Boutari, C., Doumas, M. (2015). Erectile dysfunction in chronic kidney disease: From pathophysiology to management. World Journal of Nephrology 4(3), 379-387.
- Grant, P., Jackson, G., Baig, I., Quin, J. (2013). Erectile dysfunction in general medicine. Clinical Medicine (London) 13(2), 136-140.
- Pizzol, D., Xiao, T., Yang, L., Demurtas, J., McDermott, D., Garolla, A., Nardelotto, A., Grabovac, I., Soysal, P., Kazancioglu, R.T., Veronese, N., Smith, L. (2020). Prevalence of erectile dysfunction in patients with chronic kidney disease: a systematic review and meta-analysis. International Journal of Impotence Research 33, 508-515.
Categorised in: Erectile Dysfunction
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