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. 2010 Jun;5(6):985-95.
doi: 10.2215/CJN.09081209. Epub 2010 May 24.

Treatment options for sexual dysfunction in patients with chronic kidney disease: a systematic review of randomized controlled trials

Mariacristina Vecchio  1 , Sankar D Navaneethan, David W Johnson, Giuseppe Lucisano, Giusi Graziano, Marialuisa Querques, Valeria Saglimbene, Marinella Ruospo, Carmen Bonifati, Emmanuele A Jannini, Giovanni F M Strippoli
Affiliations

Treatment options for sexual dysfunction in patients with chronic kidney disease: a systematic review of randomized controlled trials

Mariacristina Vecchio et al. Clin J Am Soc Nephrol. 2010 Jun.

Abstract

Background and objectives: Sexual dysfunction is very common in patients with chronic kidney disease (CKD), but treatment options are limited. The benefits and harms of existing interventions for treatment of sexual dysfunction were assessed in patients with CKD.

Design, setting, participants, & measurements: MEDLINE (1966 to December 2008), EMBASE (1980 to December 2008), and the Cochrane Trial Registry (Issue 4 2008) were searched for parallel and crossover randomized and quasi-randomized trials. Treatment effects were summarized as mean differences (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) using a random effects model.

Results: Fourteen trials (328 patients) were included. Phosphodiesterase-5 inhibitors (PDE5i) compared with placebo significantly increased the overall International Index of Erectile Function-5 (IIEF-5) score (three trials, 101 patients, MD 1.81, 95% CI 1.51 to 2.10), all of its individual domains, and the complete 15-item IIEF-5 (two trials, 80 patients, MD 10.64, 95% CI 5.32 to 15.96). End-of-treatment testosterone levels were not significantly increased by addition of zinc to dialysate (two trials, 22 patients, SMD 0.19 ng/dl, 95% CI -2.12 to 2.50), but oral zinc improved end-of-treatment testosterone levels. There was no difference in plasma luteinizing and follicle-stimulating hormone level at the end of the study period with zinc therapy.

Conclusions: PDE5i and zinc are promising interventions for treating sexual dysfunction in CKD. Evidence supporting their routine use in CKD patients is limited. There is an unmet need for studying interventions for male and female sexual dysfunction in CKD considering the significant disease burden.

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Figures

Figure 1.
Figure 1.
Flow chart showing the number of citations retrieved by individual searches and number of trials included in the systematic review.
Figure 2.
Figure 2.
Effect of PDE5i on IIEF-5 scores in CKD patients.
See this image and copyright information in PMC

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