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Gonadal dysfunction in chronic kidney disease.

Biff F Palmer1, Deborah J Clegg2

  • 1Department of Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA. biff.palmer@utsouthwestern.edu.

Reviews in Endocrine & Metabolic Disorders
|September 3, 2016
PubMed
Summary
This summary is machine-generated.

Sexual dysfunction is common in chronic kidney failure due to uremia and comorbid conditions. Treatments include optimizing dialysis, managing anemia, and addressing hormonal imbalances, with transplantation offering the best restoration of sexual function.

Keywords:
AmennorheaAnovulationDialysisErectile dysfunctionEstrogenGonadotropin deficiencyImpotencePituitary-gonadal axisSildenafilTestosteroneTransplantation erectile dysfunctionUremia

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Area of Science:

  • Nephrology
  • Endocrinology
  • Sexual Medicine

Background:

  • Chronic kidney failure (CKF) frequently causes sexual dysfunction in men and women.
  • Disturbances include erectile dysfunction, menstrual abnormalities, decreased libido, and fertility issues, stemming from uremia and comorbidities.
  • Psychosocial factors and fatigue also contribute to sexual health decline in CKF patients.

Purpose of the Study:

  • To review the common sexual dysfunctions in chronic kidney failure patients.
  • To discuss the underlying organic and contributing factors.
  • To outline current and potential therapeutic strategies.

Main Methods:

  • Review of literature on sexual dysfunction in chronic kidney failure.
  • Analysis of the impact of uremia and comorbid conditions.
  • Examination of hormonal axis disturbances (hypothalamic-pituitary-gonadal axis).

Main Results:

  • Uremia significantly impacts sexual function, with prominent gonadal dysfunction in men and central disturbances in women.
  • Sexual dysfunction can worsen with dialysis initiation.
  • Hormonal axis disturbances are detectable before dialysis and persist or worsen during treatment.

Conclusions:

  • Sexual dysfunction is a complex issue in CKF, influenced by uremia, comorbidities, and hormonal imbalances.
  • Management involves optimizing dialysis, treating anemia and hyperparathyroidism, and considering pharmacotherapy (e.g., sildenafil, testosterone).
  • Kidney transplantation is the most effective treatment for restoring sexual function in both men and women with CKF.