Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study

Jessica Fryckstedt; Mattias Norrbäck; Charlotte Kaviani; Britta Hylander; Jessica Fryckstedt; Mattias Norrbäck; Charlotte Kaviani; Britta Hylander

doi:10.3934/medsci.2023013

AIMS Medical Science

2023, Volume 10, Issue 2: 151-161. doi: 10.3934/medsci.2023013

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Research article

Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study

1.
Department of Emergency Medicine, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Sweden
2.
Department of Medicine, Clinical Epidemiological Division, Karolinska Institutet, Sweden
3.
Department of Internal Medicine, Visby hospital, Sweden
4.
Department of Nephrology, Karolinska University Hospital, Karolinska Institutet, Sweden
† These two authors contributed equally.

Received: 19 January 2023 Revised: 17 May 2023 Accepted: 28 May 2023 Published: 09 June 2023

Patients with Chronic Kidney Disease (CKD) report sexual dysfunction to a large extent. The objective of this study was to investigate if CKD-stage and mode of treatment correlate to self-reported experience in sexual function before and after onset of symptomatic CKD in patients without active treatment, after transplantation or on dialysis. Participants (N = 234) answered a questionnaire on frequency of sexual desire, initiative, intercourse, erection (men) /vaginal lubrication (women), and orgasm, currently and compared with before onset of symptomatic CKD. Clinical data were taken from medical charts. Within-group differences in sexual function were compared for patients without active treatment (PreT), patients with a renal transplant (Tx) and patients on dialysis treatment (D). In a subgroup analysis, five patient groups were created based on mode of treatment and CKD stage. Between-group differences in sexual function were analyzed as differences in mean composite scores and 95% CI and were estimated using ordinary least square regression with robust standard errors. In the first analysis of the study, all CKD patients reported a decrease in the frequency of sexual desire, initiative, intercourse, erection (men)/vaginal lubrication (women), and orgasm (Bonferroni p < 0.001) compared to before disease onset, irrespective of treatment mode. In the subgroup analysis, when adjusting for sex and age, dialysis patients reported a statistically significant decrease in their average score of sexual function (−2.65; 95% CI: −4.19 to −1.11; p = 0.001) compared to patients without active treatment CKD 2–3 (the reference group). The self-reported experience of CKD-patients of a deteriorating sexual function over time correlates to treatment modality and CKD stage. It is important for health-care personnel to be aware of the patients' experience of a deterioration in sexual function over time regardless of treatment modalities.
- chronic kidney disease,
- sexual dysfunction,
- erectile dysfunction,
- predialysis,
- dialysis,
- transplantation,
- uremia
Citation: Jessica Fryckstedt, Mattias Norrbäck, Charlotte Kaviani, Britta Hylander. Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study[J]. AIMS Medical Science, 2023, 10(2): 151-161. doi: 10.3934/medsci.2023013

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Abstract

Patients with Chronic Kidney Disease (CKD) report sexual dysfunction to a large extent. The objective of this study was to investigate if CKD-stage and mode of treatment correlate to self-reported experience in sexual function before and after onset of symptomatic CKD in patients without active treatment, after transplantation or on dialysis. Participants (N = 234) answered a questionnaire on frequency of sexual desire, initiative, intercourse, erection (men) /vaginal lubrication (women), and orgasm, currently and compared with before onset of symptomatic CKD. Clinical data were taken from medical charts. Within-group differences in sexual function were compared for patients without active treatment (PreT), patients with a renal transplant (Tx) and patients on dialysis treatment (D). In a subgroup analysis, five patient groups were created based on mode of treatment and CKD stage. Between-group differences in sexual function were analyzed as differences in mean composite scores and 95% CI and were estimated using ordinary least square regression with robust standard errors. In the first analysis of the study, all CKD patients reported a decrease in the frequency of sexual desire, initiative, intercourse, erection (men)/vaginal lubrication (women), and orgasm (Bonferroni p < 0.001) compared to before disease onset, irrespective of treatment mode. In the subgroup analysis, when adjusting for sex and age, dialysis patients reported a statistically significant decrease in their average score of sexual function (−2.65; 95% CI: −4.19 to −1.11; p = 0.001) compared to patients without active treatment CKD 2–3 (the reference group). The self-reported experience of CKD-patients of a deteriorating sexual function over time correlates to treatment modality and CKD stage. It is important for health-care personnel to be aware of the patients' experience of a deterioration in sexual function over time regardless of treatment modalities.

Abbreviations

CKD

Chronic kidney disease

CKD 1–5

Chronic kidney disease stage 1–5

PreT

Pretreatment

PreT 2–3

Pretreatment patients in CKD stages 2–3

PreT 4–5

Pretreatment patients in CKD stages 4–5

Dialysis

Transplanted patients

Tx 2–3

Patients with a renal transplant in CKD stages 2–3

Tx 4–5

Patients with a renal transplant in CKD stages 4–5

BMI

Body Mass Index

GFR

Glomerular Filtration Rate

IIEF

International Index of Erectile function questionnaire

FSFI

Female Sexual Function Index questionnaire

Erectile Dysfunction

RSS

Relationship and Sexuality Scale

ACE

Angiotensin converting enzyme

ARB

Angiotensin II receptor blockers

PTH

Parathyroid Hormone

OLS regression

Ordinary least square regression

IQR

Interquartile range

SLE

Systemic lupus erythematosus

EPO

Erytropoietin

Acknowledgments

Many thanks to the collaborators below who contributed in recruiting patients from their respective Nephology Units: Lilian Zezina, MD, PhD, Mälarsjukhuset, Eskilstuna; Michael Gylling, RN, Anders Fernström, MD, PhD, Linköping University Hospital; Sonia Osagie, MD, Nyköping Hospital; Boa Grönroos, MD, Danderyd Hospital; Gunilla Welander, MD, Karlstad Hospital.

Use of AI tools declaration

The authors declare they have not used Artificial Intelligence (AI) tools in the creation of this article.

Conflict of interest

All authors declare no conflict of interest in this paper.

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