Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jul 6, 2015; 4(3): 379-387
Published online Jul 6, 2015. doi: 10.5527/wjn.v4.i3.379
Erectile dysfunction in chronic kidney disease: From pathophysiology to management
Eirini Papadopoulou, Anna Varouktsi, Antonios Lazaridis, Chrysoula Boutari, Michael Doumas
Eirini Papadopoulou, Anna Varouktsi, Antonios Lazaridis, Chrysoula Boutari, Michael Doumas, 2nd Propaedeutic Department of Internal Medicine, Aristotle University, 54643 Thessaloniki, Greece
Author contributions: Papadopoulou E and Doumas M conceived the idea of the manuscript; Papadopoulou E, Varouktsi A, Lazaridis A, and Boutari C performed the systematic search of the literature and drafted different parts of the manuscript; Doumas M overviewed the final draft; all authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Michael Doumas, Associate Professor, 2nd Propaedeutic Department of Internal Medicine, Aristotle University, 49 Konstantinoupoleos street, 54643 Thessaloniki, Greece.
Telephone: +30-2310-992836 Fax: +30-2310-992834
Received: November 20, 2014
Peer-review started: November 22, 2014
First decision: December 12, 2014
Revised: April 3, 2015
Accepted: May 27, 2015
Article in press: May 28, 2015
Published online: July 6, 2015

Chronic kidney disease (CKD) is encountered in millions of people worldwide, with continuously rising incidence during the past decades, affecting their quality of life despite the increase of life expectancy in these patients. Disturbance of sexual function is common among men with CKD, as both conditions share common pathophysiological causes, such as vascular or hormonal abnormalities and are both affected by similar coexisting comorbid conditions such as cardiovascular disease, hypertension and diabetes mellitus. The estimated prevalence of erectile dysfunction reaches 70% in end stage renal disease patients. Nevertheless, sexual dysfunction remains under-recognized and under-treated in a high proportion of these patients, a fact which should raise awareness among clinicians. A multifactorial approach in management and treatment is undoubtedly required in order to improve patients’ quality of life and cardiovascular outcomes.

Keywords: Chronic kidney disease, Erectile dysfunction, Management, Quality of life, Hypertension, Diabetes mellitus, Phosphodiesterase-5 inhibitors

Core tip: Erectile dysfunction is highly prevalent among patients with chronic kidney disease in rates that reach even 70%, especially in those suffering from end stage renal disease. The rates of patients suffering from sexual dysfunction tend to be higher when additional risk factors, such as coronary artery disease, diabetes mellitus, hypertension or prescription of antihypertensive drugs, coexist. Integrated management of these patients through lifestyle measures, hormonal replacement, and use of drugs such as phosphodiesterase-5 inhibitors, is essential in order to improve sexual function among these patients, thereby maintaining a satisfactory quality of life.