[Sexual dysfunction in the male patients on hemodialysis]

Several features of sexual dysfunction, such as infertility, decreased libido and potency, are frequently observed in male patients with uremia, and it usually worsens with time despite of hemodialysis(HD) therapy. Hormonal profile often demonstrates hypergonadotropic hypogonadism, and is suggestive of primary Leydig cell dysfunction. Hypotestosteronemia and hyperprolactinemia may partially participate in the pathogenesis of sexual dysfunction. Uremic toxins, renal anemia, hyperparathyroidism, zinc deficiency, vascular and neurologic abnormalities are also reported to be the causative factors of sexual dysfunction. Correction of anemia with recombinant human erythropoietin sometimes results in the amelioration of sexual potency, probably due to improvement of erectile performance by increased blood viscosity. Psychological derangement should be kept in mind as an another factor of sexual dysfunction.