Determinants of Sexual Satisfaction in Hemodialysis Patients: A Cross-Sectional Analysis with Healthy Controls

Background and Objectives: Sexual satisfaction is a distinct patient-centered outcome in hemodialysis. Yet its links to routine dialysis parameters remain unclear. To examine sexual satisfaction-assessed with the Sexual Satisfaction Scale (SSS)-in adults receiving maintenance hemodialysis in relation to demographic and dialysis parameters, and to compare SSS scores with healthy controls. Materials and Methods: Cross-sectional study of adults on maintenance hemodialysis (n = 72) and controls (n = 52). Sexual satisfaction was measured with the SSS (higher scores indicate greater dissatisfaction) among respondents with one primary partner. Demographic, clinical, and dialysis variables (shift, session duration, access, vintage, ultrafiltration, predialysis urea, Kt/V, urea reduction ratio), as well as transplant history/intent, were recorded. Group comparisons used t/Welch tests or ANOVA; correlations used Pearson's r. Results: The SSS did not differ by sex, marital status, education, vascular access, dialysis shift, session duration, or adequacy indices. Prior kidney transplantation was associated with significantly lower SSS scores (mean 9.73 vs. 14.49; p = 0.0047), indicating better sexual satisfaction. Conclusions: Sexual dissatisfaction is common yet largely independent of routine demographic and dialysis metrics. Only previous kidney transplantation showed a significant association with sexual satisfaction in our cohort (p = 0.0047). Findings support a biopsychosocial, patient-centered approach and routine attention to sexual health in hemodialysis care.