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.
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.
Authors: Alexander Tsertsvadze; Howard A Fink; Fatemeh Yazdi; Roderick MacDonald; Anthony J Bella; Mohammed T Ansari; Chantelle Garritty; Karla Soares-Weiser; Raymond Daniel; Margaret Sampson; Steven Fox; David Moher; Timothy J Wilt Journal: Ann Intern Med Date: 2009-11-03 Impact factor: 25.391
Authors: Amir Qaseem; Vincenza Snow; Thomas D Denberg; Donald E Casey; Mary Ann Forciea; Douglas K Owens; Paul Shekelle Journal: Ann Intern Med Date: 2009-11-03 Impact factor: 25.391
Authors: Giovanni F M Strippoli; Mariacristina Vecchio; Suetonia Palmer; Giorgia De Berardis; Jonathan Craig; Giuseppe Lucisano; David Johnson; Fabio Pellegrini; Antonio Nicolucci; Michela Sciancalepore; Valeria Saglimbene; Letizia Gargano; Carmen Bonifati; Marinella Ruospo; Sankar D Navaneethan; Vincenzo Montinaro; Paul Stroumza; Marianna Zsom; Mariatta Torok; Eduardo Celia; Ruben Gelfman; Anna Bednarek-Skublewska; Jan Dulawa; Giusi Graziano; Giorgio Gentile; Juan Nin Ferrari; Antonio Santoro; Annalisa Zucchelli; Giorgio Triolo; Stefano Maffei; Jörgen Hegbrant; Charlotta Wollheim; Salvatore De Cosmo; Valeria M Manfreda Journal: Clin J Am Soc Nephrol Date: 2012-04-05 Impact factor: 8.237
Authors: Adam Bass; Sofia B Ahmed; Scott Klarenbach; Bruce Culleton; Brenda R Hemmelgarn; Braden Manns Journal: BMC Nephrol Date: 2012-07-26 Impact factor: 2.388
Authors: Giovanni F M Strippoli; Suetonia C Palmer; Marinella Ruospo; Patrizia Natale; Valeria Saglimbene; Jonathan C Craig; Fabio Pellegrini; Massimo Petruzzi; Michele De Benedittis; Pauline Ford; David W Johnson; Eduardo Celia; Ruben Gelfman; Miguel R Leal; Marietta Torok; Paul Stroumza; Anna Bednarek-Skublewska; Jan Dulawa; Luc Frantzen; Juan Nin Ferrari; Domingo del Castillo; Jorgen Hegbrant; Charlotta Wollheim; Letitzia Gargano Journal: BMC Nephrol Date: 2013-04-19 Impact factor: 2.388