[Sexual dysfunction in males with chronic kidney disease]

Area of Science:

• Nephrology
• Andrology
• Endocrinology

Background:

• Sexual dysfunction is a prevalent complication in men with chronic kidney disease (CKD).
• Erectile dysfunction (ED) is the most frequent clinical presentation of sexual dysfunction in this population.
• The condition is linked to endocrine system malfunctions, including hypothalamic-pituitary-gonadal axis disorders and hyperprolactinemia.

Purpose of the Study:

• To review recent advancements in understanding sexual dysfunction in men with CKD.
• To cover the risk factors, etiology, pathophysiology, diagnosis, and treatment of sexual dysfunction in CKD.

Main Methods:

• Literature review of recent studies on sexual dysfunction in CKD.
• Analysis of risk factors, including endocrine, vascular, neurological, psychological, and iatrogenic elements.
• Examination of current diagnostic approaches and therapeutic strategies.

Main Results:

• Sexual dysfunction in CKD men is multifactorial, involving endocrine, vascular, neurological, and psychological aspects.
• Key endocrine disruptions include HPG axis dysfunction and hyperprolactinemia.
• Diagnosis relies on scales, clinical presentation, and specific examinations.
• Treatment strategies involve correcting endocrine imbalances (e.g., kidney transplantation, hormone therapy, zinc), and supplementary treatments like PDE5 inhibitors.

Conclusions:

• Sexual dysfunction is a significant issue for men with CKD, stemming from complex pathophysiological mechanisms.
• Effective management requires a comprehensive approach targeting the underlying causes and contributing factors.
• Further research is needed to optimize diagnostic and therapeutic interventions for sexual dysfunction in CKD patients.