Background: Health-related quality of life (QOL) is affected in hemodialysis patients (HD). A number of factors such as age, anemia, and comorbidity had been implicated in decreased QOL. Erectile dysfunction (ED) is a frequent and potentially treatable complication in HD patients. In this cross-sectional study, we aimed to evaluate the possible relation between the QOL and ED in HD patients. Patients and Methods: Among the 511 chronic HD patients dialyzed in 11 outpatient HD centers, 148 male patients (mean age: 46 ± 9 years) were included. The mean time on dialysis was 41 ± 35 months (range: 3–203 months). Biochemical parameters such as BUN, creatinine, hemoglobin, serum albumin and Kt/V were measured. The QOL of the patients were measured with the short form of Medical Outcomes Study (SF-36), physical component scores (PCS) and mental component scores (MCS) were calculated. The ED was evaluated by the International Index of Erectile Function (IIEF). Results: One hundred and four of the 148 patients (70%) had ED. Hemoglobin levels were correlated with PCS (r = 0.197, p = 0.02) and MCS (r = 0.20, p = 0.019). Patients with ED had lower scores in nearly all the components related to PCS and MCS as compared to patients without ED. IIEF score was correlated with PCS (r = 0.369, p < 0.001) and MCS (r = 0.308, p < 0.001). In linear regression analysis, IIEF score and hemoglobin levels were the independent variables that predicted both PCM and MCS. Conclusion: ED, a frequent complication in HD patients, was related to QOL together with anemia. Successful treatment of ED and anemia may lead to improvement in QOL in HD patients.

1.
Mittal SK, Ahern L, Flaster E, Maesaka JK, Fishbane S: Self-assessed physical and mental function of haemodialysis patients. Nephrol Dial Transplant 2001;16:1387–1394.
2.
Blake C, Codd MB, Cassidy A, O’Meara YM: Physical function, employment and quality of life in end-stage renal disease. J Nephrol 2000;13:142–149.
3.
DeOreo PB: Hemodialysis patients assessed functional health status predicts continued survival, hospitalization and dialysis-attendance compliance. Am J Kidney Dis 1997;30:204–212.
4.
Valderrabano F, Jofre R, Lopez-Gomez JM: Quality of life in end stage renal disease patients. Am J Kidney Dis 2001;38:443–464.
5.
Walters BAJ, Hays RD, Spritzer KL, Fridman M, Carter WB: Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. Am J Kidney Dis 2002;40:1185–1194.
6.
Bakewell AB, Higgins RM, Edmunds ME: Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes. Kidney Int 2002;61:239–248.
7.
Moreno F, Lopez-Gomez JM, Sanz Guajardo D, Jofre R, Valderrabano F: The Spanish Cooperative Renal Patients Quality of Life Study Group: Quality of life in dialysis patients. Nephrol Dial Transplant 1996;11(suppl 2):S125–129.
8.
Mingardi G, Cornalba L, Cortinovis E, et al: Health-related quality of life in dialysis patients: A report from an Italian study using the SF-36 Health Survey. Nephrol Dial Transplant 1999;14:1503–1510.
9.
Turk S, Karalezli G, Tonbul HZ, Yildiz M, Altintepe L, Yildiz A, Yeksan M: Erectile dysfunction and the effects of Sildenafil treatment on hemodialysis and continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 2001;16:1818–1822.
10.
Rosas SE, Joffe M, Franklin E, et al: Prevalence and determinants of erectile dysfunction in hemodialysis patients. Kidney Int 2001;59:2259–2266.
11.
Ware JE, Sherbourne CD: The MOS 36-Item Short-Form Health Survey (SF-36) I: Conceptual framework and item selection. Med Care 1992;30:473–483.
12.
Ware Jr JE: SF-36 Health Survey Manual and Interpretation Guide. Boston, Health Institute, New England Medical Center, 1993.
13.
Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A: Comparison of methods for scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the medical outcomes Study. Med Care 1995;33:AS264–AS279.
14.
Johansen KL, Painter P, Kent-Braun JA, et al: Validation of questionnaires to estimate physical activity and functioning in end-stage renal disease. Kidney Int 2001,59:1121–1127.
15.
Rosen RC, Riley A, Wagner G, et al: The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822–830.
16.
Cappelleri JC, Rosen RC, Smith MD, Mishra A, Osterloch IH: Diagnostic evaluation of the erectile function domain of the international index of erectile function. Urology 1999;54:346–351.
17.
Declaration of Helsinki. Recommendations Guiding Physicians in Biomedical Research Involving Human Subjects, 41st World Medical Assembly, Hong Kong, 1989.
18.
Ifudu O, Paul HR, Homel P, Friedman EA: Predictive value of functional status for mortality in patients on maintenance hemodialysis. Am J Nephrol 1998;18:109–116.
19.
Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, Schwab SJ, Goodkin DA: The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoietin. N Engl J Med 1998;339:584–590.
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