Renal replacement therapy tied to worse sexual dysfunction

Sexual dysfunction (SD) is worse among patients with chronic renal failure (CRF) receiving renal replacement therapy, reports a new meta-analysis.

A search of online databases yielded 10 studies eligible for quantitative analysis, totalling 3,725 participants, 737 of whom were CRF patients undergoing renal replacement therapy. Six of the included studies were case-control in design; five studies looked into female SD (FSD) as an outcome, four considered erectile dysfunction (ED), and one reported both.

Pooled analysis revealed that renal replacement therapy in CRF patients significantly increased the risk of FSD (relative risk [RR], 2.07, 95 percent confidence interval [CI], 1.47–2.91; p=0.000) and ED (RR, 2.95, 95 percent CI, 2.16–4.02; p=0.000). In both analyses, heterogeneity of evidence was significant (p=0.000 for both).

Stratifying according to the different types of renal replacement therapy, the researchers found that peritoneal dialysis (RR, 2.33, 95 percent CI, 1.29–4.21; p=0.000) and haemodialysis (RR, 2.23, 95 percent CI, 1.52–3.28; p=0.000) were stronger risk factors for FSD than renal transplant (RR, 1.80, 95 percent CI, 1.04–3.12; p=0.000).

In men, peritoneal dialysis (RR, 8.00, 95 percent CI, 5.69–11.25; p=0.000), haemodialysis (RR, 3.03, 95 percent CI, 2.20–4.17; p=0.000), and renal transplant (RR, 3.58, 95 percent CI, 1.45–8.83; p=0.000) all worsened ED risk relative to controls.

“Given its association with SD, in clinical practice, the assessment of sexual function and specific treatments are necessary for patients receiving renal replacement therapy to improve the quality of life,” the researchers said.

“However, this evidence was derived from limited studies. Further high-quality, prospective, multicentre studies with long follow-up time are still needed to confirm our result,” they added.