Treatment of sexual dysfunctions in patients with chronic kidney disease

Česká verzia

Authors: R. Zachoval; J. Jarabák
Authors place of work: Urologické oddělení ; Primář: doc. MUDr. Roman Zachoval, PhD. ; Thomayerova nemocnice, Praha
Published in the journal: Prakt. Lék. 2012; 92(3): 163-167
Category: Of different specialties

Summary

Sexual dysfunction is very common in patients with chronic kidney disease, but it is still significantly understudied. Treatment options exist but concerns have been raised relating to their efficacy and safety in chronic kidney disease. We assessed the benefits and harms of existing treatments for sexual dysfunction in patients with chronic kidney disease.

We searched the Cochrane Renal Group specialised register, MEDLINE and EMBASE. Randomised controlled trials of any pharmacological and non-pharmacological interventions used to treat sexual dysfunction in male chronic kidney disease were included.Fifteen studies (8 parallel, 7 crossover, 352 patients) were included.

These studies evaluated

the effects of phosphodiesterase-5 inhibitors,
zinc,
vitamin E,
vitamin D, or
bromocriptine

compared to placebo.

Phosphodiesterase-5 inhibitors significantly increased the overall International Index of Erectile Function-5 score, all its individual domains and the complete 15-item International Index of Erectile Function tool. At the end of treatment, testosterone levels were not significantly increased by the addition of zinc to dialysate, but oral zinc did improve end of treatment testosterone levels.

There was no difference in plasma luteinizing and follicle-stimulating hormone levels at the end of the study period and there were no studies of intracavernous injections, transurethral injections, mechanical device or psychosexual therapies in men with chronic kidney disease.

Phosphodiesterase-5 inhibitors and zinc are promising interventions for treating sexual dysfunction in men with chronic kidney disease. Evidence supporting their routine use in chronic kidney disease patients is limited.

Key words:
chronic kidney disease, sexual dysfunctions, erectile function, phosphodiesterase-5 inhibitors, zinc.

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