Sexual dysfunction in chronic renal failure

Recent studies have shown that testosterone is involved in the pathogenesis of cardiovascular diseases. More- over, in observational studies blood testosterone con- centrations, resulted consistently lower, not only among men with cardiovascular disease but also in men with uremia. In order to correlate the blood level of testos- terone with the degree of erectile dysfunction (ED) and chronic renal failure (CRF) (stage I-V) we selected a group of patients with renal failure on conservative treat- ment, who attended our nephrology outpatients clinic. All the patients had stage II and III renal failure, respec- tively with a creatinine clearance between 59-30 and 29- 15 ml/m’. The sexual evaluation was done using a 15- item questionnaire, i.e. the International Index of Erectile Function (IIEF). Mean score of patients with ED were significantly lower than mean scores for healthy controls for all 15 ques- tions (all p values <0.01). Preliminary results show a di- rect correlation between -IIEF and gromerular filtration rate (GFR) (R2 0.08); an inverse correlation between testosterone and cholesterol (R2 0.045); a higher number of diabetic patients with lower levels of testosterone, at level 3 of CRF; low levels of testosterone for smokers es- pecially in stage II (GFR). These data confirm the direct correlation between ED and renal failure, and the role of diabetes and smoking in hypotestosteronemia, in pa- tients with different degrees of renal insufficiency. Fur- ther prospective studies are needed in order to correlate cardiovascular morbidity and mortality in patients with CRF and blood levels of testosterone.