Prevalence and correlates of erectile dysfunction in men on chronic haemodialysis: A multinational cross-sectional study

Mariacristina Vecchio, Suetonia Palmer, Giorgia De Berardis, Jonathan Craig, 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-SkublewskaJan Dulawa, Giusi Graziano, Giuseppe Lucisano, Giorgio Gentile, Juan Nin Ferrari, Antonio Santoro, Annalisa Zucchelli, Giorgio Triolo, Stefano Maffei, Jörgen Hegbrant, Charlotta Wollheim, Salvatore De Cosmo, Valeria M. Manfreda, Giovanni F M Strippoli, D. Rubio, W. Labonia, M. Prado, A. Vinockur, R. Paparone, C. Mato Mira, A. Penãlba, M. Gravielle, E. Mojico, M. Vargas, S. Tirado, M. Paz, G. Rodriguez, L. López, R. Beistegui, C. Bonelli, Collaborative Depression and Sexual dysfunction (CDS) in Hemodialysis Working Group

Research output: Contribution to journalArticlepeer-review


Background. Factors associated with erectile dysfunction in men on haemodialysis are incompletely identified due to suboptimal existing studies. We determined the prevalence and correlates of erectile dysfunction and identified combinations of clinical characteristics associated with a higher risk of erectile dysfunction using recursive partitioning and amalgamation (REPCAM) analysis. Methods. We conducted a multinational cross-sectional study in men on haemodialysis within a collaborative network. Erectile dysfunction and depressive symptoms were evaluated using the erectile function domain of the International Index of Erectile Function questionnaire and the Center for Epidemiological Studies-Depression Scale, respectively. Results. Nine hundred and forty-six (59%) of 1611 eligible men provided complete data for erectile dysfunction. Eighty-three per cent reported erectile dysfunction and 47% reported severe erectile dysfunction. Four per cent of those with erectile dysfunction were receiving pharmacological treatment. Depressive symptoms were the strongest correlate of erectile dysfunction [adjusted odds ratio 2.41 (95% confidence interval (CI) 1.57-3.71)]. Erectile dysfunction was also associated with age (1.06, 1.05-1.08), being unemployed (1.80, 1.17-2.79) or receiving a pension (2.05, 1.14-3.69) and interdialytic weight gain (1.9-2.87 kg, 1.92 [CI 1.19-3.09]; > 2.87 kg, 1.57 [CI 1.00-2.45]). Married men had a lower risk of erectile dysfunction (0.49, 0.31-0.76). The prevalence of erectile dysfunction was highest (94%) in unmarried and unemployed or retired men who have depressive symptoms. Conclusions. Most men on haemodialysis experience erectile dysfunction and are untreated. Given the prevalence of this condition and the relative lack of efficacy data for pharmacological agents, we suggest that large trials of pharmacological and non-pharmacological interventions for erectile dysfunction and depression are needed.

Original languageEnglish
Pages (from-to)2479-2488
Number of pages10
JournalNephrology Dialysis Transplantation
Issue number6
Publication statusPublished - 2012


  • Depression
  • Erectile dysfunction
  • Haemodialysis
  • Sexual function

ASJC Scopus subject areas

  • Nephrology
  • Transplantation


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