[Erectile function of renal failure patients after hemodialysis or kidney transplantation: A comparative study]

To study the changes in the erectile function of the male patients with renal failure after hemodialysis (HD) or kidney transplantation (KT) and explore the causes of these changes.

From January 2015 to January 2021, 160 male patients with renal failure complaining of ED underwent HD (n = 80) or KT (n = 80) in the General Hospital of Eastern Theater Command. The patients were aged 25－45 (31.7 ± 4.8) years, 32 ± 4.5 years in the HD group and 31.4 ± 5.1 years in the KT group. We recorded the levels of serum T, E2, FSH and LH and the scores on IIEF-5, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) of the patients, and compared them between the two groups.

Compared with the patients in the HD group, those in the KT group showed a significantly higher T level (［7.45 ± 3.54］ vs ［17.75 ± 7.32］ nmol/L, P < 0.01) and a lower E2 level (［151.37 ± 20.89］ vs ［94.17 ± 40.79］ pmol/L, P < 0.01), but no statistically significant difference from the former group in the levels of FSH (［8.12 ± 5.12］ vs ［8.97 ± 2.36］ IU/L, P > 0.05) and LH (［5.16 ± 3.87］ vs ［4.69 ± 2.18］ IU/L, P > 0.05). There were fewer cases of severe ED in the KT than in the HD group (3.75% vs 16.25%, P < 0.05). Different degrees of anxiety and depression were observed in both groups, with fewer severe cases of anxiety (6.25% vs 30.00%, P < 0.05) and depression (6.25% vs 31.25%, P < 0.05) and more mild cases of anxiety (68.75% vs 47.50%, P < 0.05) and depression (70.00% vs 48.75%, P < 0.05) in the KT than in the HD group, but no statistically significant difference in the incidence of moderate anxiety (25.00% vs 22.50%, P > 0.05) and depression (23.75% vs 20.00%, P > 0.05) between the KT and HD groups.

For male patients with renal failure, kidney transplantation can evidently improve erectile function, while hemodialysis has a poorer effect. The altered hormone levels, anxiety and depression of the patients are important causes of the changes in their erectile function.