The relationship between physical inactivity and sexual dysfunction among patients receiving hemodialysis

Chronic Kidney Disease (CKD), in its final stage, requires renal replacement therapy, such as hemodialysis (HD) to maintain vital functions; nevertheless, it imposes lifestyle changes. For example, physical activity (PA) levels are lower than the World Health Organization recommendations, consequently affecting physical performance. On the other hand, up to 80% of patients receiving HD have reported sexual dysfunction. Therefore, this study aimed to associate physical inactivity with sexual dysfunction in patients receiving HD.

an analytical cross-sectional study was conducted on 116 ambulatory HD patients. Self-reported questionnaires for sexual dysfunction, IIEF and IFSF, and physical performance tests, such as the IPAQ-SF for physical activity levels, the six-minute walk test, the handgrip strength test, and the sit-to-stand test, were used to assess patients. A multivariate regression model was performed to identify predictors of sexual dysfunction.

86.4% of women and 84.2% of the men reported sexual dysfunction. An association between physical inactivity and sexual dysfunction was found (OR = 5.6, 95% CI 1.77-17.71, p = 0.003). Logistic regression revealed that PA (OR = 0.997, p = 0.004), diabetes (OR = 7.558, p = 0.028), handgrip strength (OR = 1.819, p =  < 0.001), and sit-to-stand repetitions (OR = 0.779, p = 0.004) were predictors of sexual dysfunction.

Our study found that physical inactivity increases the risk of sexual dysfunction in CKD patients receiving HD, where the presence of diabetes is the main risk factor, and physical performance has a protective effect. Therapeutic exercise programs should be implemented as part of an integral approach in HD units, to improve patients' physical and sexual function.