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Sexual dysfunction in chronic renal failure.

Guido Bellinghieri1, Domenico Santoro, Agostino Mallamace

  • 1Division of Nephrology and Dialysis, University of Messina, Policlinico Universitario, Viale Gazzi, Messina, Italy. gbellinghieri@hotmail.com

Journal of Nephrology
|July 2, 2008
PubMed
Summary

Low testosterone levels are linked to erectile dysfunction (ED) and chronic renal failure (CRF). Diabetes and smoking exacerbate these low testosterone levels in men with kidney disease.

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Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Testosterone plays a role in cardiovascular disease pathogenesis.
  • Lower blood testosterone concentrations are observed in men with cardiovascular disease and uremia.
  • Erectile dysfunction (ED) is a common comorbidity in men with chronic renal failure (CRF).

Purpose of the Study:

  • To correlate blood testosterone levels with the severity of erectile dysfunction (ED) and chronic renal failure (CRF) stages.
  • To investigate the influence of diabetes and smoking on testosterone levels in patients with renal insufficiency.

Main Methods:

  • A group of patients with conservative-treated renal failure (Stage II-III) were selected.
  • Sexual function was assessed using the International Index of Erectile Function (IIEF) questionnaire.
  • Blood testosterone levels, creatinine clearance, and cholesterol were measured.

Main Results:

  • Patients with ED had significantly lower IIEF scores compared to healthy controls (p<0.01).
  • A direct correlation was found between IIEF scores and glomerular filtration rate (GFR) (R2=0.08).
  • An inverse correlation existed between testosterone and cholesterol (R2=0.045).
  • Diabetic patients and smokers, particularly in Stage II CRF, exhibited lower testosterone levels.

Conclusions:

  • ED is directly correlated with the degree of renal failure.
  • Diabetes and smoking contribute to hypotestosteronemia in patients with renal insufficiency.
  • Further studies are needed to explore the link between testosterone levels, cardiovascular outcomes, and CRF.