Sexual Function And Quality Of Life Among Hemodialysis Patients | 53542
Journal of Nephrology & Therapeutics
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Sexual dysfunction (SD) occurs in both among men and women with end-stage renal disease (ESRD) undergoing hemodialysis
(HD). There are contradictory data about SD’s impacts on patients’ quality of life (QOL) according to gender. It seems that impacts
of SD on QOL can be quite different among men and women. Indeed, there are studies showing that women are less emotionally
affected by SD than men. We conducted three studies in this area encompassing ESRD patients undergoing HD in the only two
dialysis centers in Northern Ceará state, Northeast Brazil. In all studies, we used the Brazilian version of the Medical Outcomes Study
36-Item Short Form Health Questionnaire (SF-36) to assess QOL level. SF-36 covers eight dimensions of QOL: Physical Functioning,
Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health. Among men between
20 and 50 years of age, the International Index of Erectile Function Index (IIEF) was used to measure erectile function. In turn,
among sexually active women with age between 18 and 55 years, we used the Female Sexual Function Index (FSFI), which evaluates
six domains of sexual function: Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain. We found 42.4% prevalence of erectile
dysfunction (ED) among men. Men with ED presented lower scores concerning all QOL dimensions when compared to men without
ED. However, only the Mental Health dimension was significantly different. On the other hand, we found SD in 79.3% of women.
Scores related to Physical Functioning, Bodily Pain, Vitality and Social Functioning were significantly lower among women with SD
compared to women without SD. Moreover, the presence of SD was an independent predictor of depression among women on HD,
increasing nearly six times the risk of depressive symptoms, as assessed by the Center for Epidemiologic Studies Depression Scale
(CES-D). We concluded that ED and SD affect QOL of men and women in different ways. Among men with ED, the mental aspect of
QOL (represented by the dimension Mental Health) is more affected, while among women the physical aspect of QOL (represented
by the dimensions Physical Functioning, Bodily Pain, Vitality and Social Functioning) is more affected by SD. We concluded that
routine screening of sexual function is necessary among HD patients aiming to detect SD, which is a treatable variable associated with
poor QOL. In addition, after the start of therapy for SD, effects of the treatment on QOL dimensions should be checked to ensure an
efficient result, taking into consideration the differences regarding gender.
Paulo Roberto Santos is Associate Professor at Federal University of Ceará, Brazil and coordinates the Graduate Program in Health Sciences of the Sobral Faculty of Medicine. His main research interests are self-perceived outcomes (quality of life, depression, coping strategies and sexuality) among end-stage renal disease patients.