1. Prevalence and Correlates of Self-Reported Sexual Dysfunction in CKD: A Meta-analysis of Observational Studies
- Author
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Valeria Maria Manfreda, Charlotta Wollheim, Jörgen Hegbrant, Jan Duława, Carmen Bonifati, Marietta Török, Giorgio Gentile, Valeria Saglimbene, Anna Bednarek-Skublewska, Emmanuele A. Jannini, Eduardo Celia, Marinella Ruospo, Mariacristina Vecchio, Giusi Graziano, Jonathan C. Craig, David W. Johnson, Paul Stroumza, Marialuisa Querques, Fabio Pellegrini, Juan Nin Ferrari, Ruben Gelfman, Giovanni F.M. Strippoli, Sankar D. Navaneethan, and Giuseppe Lucisano
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Comorbidity ,Risk Assessment ,Renal Dialysis ,Internal medicine ,Epidemiology ,Prevalence ,medicine ,Humans ,Sexual Dysfunctions, Psychological ,Sex Distribution ,education ,Dialysis ,education.field_of_study ,business.industry ,Prognosis ,medicine.disease ,Kidney Transplantation ,Surgery ,Sexual Dysfunction, Physiological ,Sexual dysfunction ,Erectile dysfunction ,Nephrology ,Meta-analysis ,Quality of Life ,Kidney Failure, Chronic ,Female ,medicine.symptom ,business ,Kidney disease - Abstract
Background: Sexual dysfunction is an under-recognized problem in men and women with chronic kidney disease (CKD). The prevalence, correlates, and predictors of this condition in patients with CKD have not been evaluated comprehensively. Study Design: Systematic review and meta-analysis. Setting & Population: Patients treated using dialysis (dialysis patients), patients treated using transplant (transplant recipients), and patients with CKD not treated using dialysis or transplant (nondialysis nontransplant patients with CKD). Selection Criteria for Studies: Observational studies conducted in patients with CKD only or including a control group without CKD. Predictor: Type of study population. Outcomes: Sexual dysfunction in men and women with CKD using validated tools, such as the International Index of Erectile Function, the Female Sexual Function Index (FSFI), or other measures as reported by study investigators. Results: 50 studies (8,343 patients) of variable size (range, 16-1,023 patients) were included in this review. Almost all studies explored sexual dysfunction in men and specifically erectile dysfunction. The summary estimate of erectile dysfunction in men with CKD was 70% (95% CI, 62%-77%; 21 studies, 4,389 patients). Differences in reported prevalence rates of erectile dysfunction between different studies were attributable primarily to age, study populations, and type of study tool used to assess the presence of erectile dysfunction. In women, the reported prevalence of sexual dysfunction was assessed in only 306 patients from 2 studies and ranged from 30%-80%. Compared with the general population, women with CKD had a significantly lower overall FSFI score (8 studies or subgroups, 407 patients; mean difference, 9.28; 95% CI, 12.92 to 5.64). Increasing age, diabetes mellitus, and depression consistently were found to correlate with sexual dysfunction in 20 individual studies of patients with CKD using different methods. Limitations: Suboptimal and lack of uniform assessment of outcome measures. Conclusions: Sexual dysfunction is highly prevalent in both men and women with CKD, especially among those on dialysis. Larger studies enrolling different ethnic groups, using validated
- Published
- 2010
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