Metabolic Acidosis and Sexual Dysfunction in Chronic Kidney Patients; Who do not Receive Renal Replacement Therapy ,Cross-sectional study in a single center

Abstract

Abstract In this study, it is aimed to investigate the prevalence of sexual disorders in patients in stage 2–5 stage chronic kidney disease and its relationship with laboratory parameters, including demographic, clinical and especially metabolic acidosis. This is a cross-sectional study consisting of 110 predialysis patients with chronic kidney disease and 110 healthy controls admitted to nephrology out-patient clinics. IIEF (International Index of Erectile Function) and FSFI (Female Sexual Function Index) questionnaire was applied to the patients and control group. The relationship between demographic, clinical and various biochemical parameters, sexual dysfunction in the patient group was assessed. Sexual dysfunction was detected in 76% of the female patients and 31.4% of the control group.FSFI total. Subscale scores of the patients were significantly lower than the control group. In male patients and controls, the frequency of erectile dysfunction was 56.7% and 33.3% respectively. The erectile function, sexual satisfaction and overall satisfaction scores of the IIEF scale were significantly lower than the control group. Female patients reported %40 regular menstrual cycles. Advanced age was associated with loss of libido in female patients, while erectile dysfunction was associated with loss of libido, orgasmic disturbance and sexual dissatisfaction in male patients. Low Glomerular filtration rate(GFR), high calcium(Ca) levels, increased CRP, anemia and metabolic acidosis in both genders. Testosterone deficiency in male patients were associated with sexual dysfunction. In multiple regression analysis, eGFR was the only independent variable associated with sexual dysfunction. The increase in Parathormone (PTH) and Prolactin levels was related to the loss of libido in both genders. Sexual dysfunction is widely observed in male and female patients with chronic kidney disease. There is a need for public awareness of sexual dysfunction, as well as specific studies to better characterize, assess, understand and treat. Clinical Implications:. Despite common neglect,sexual disorders in chronic kidney disease can be optimized with simple precautions Strengths&Limitations: This study contributes to the literature in sexual dysfunction about female CKD patients. Another prospective study should enstrength the findings. Conclusion: Metabolic acidosis and low eGFR seem to be the most important risk factors contributing sexual disorders in CKD patients.