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

Mariacristina Vecchio, 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

Research output: Contribution to journalArticle

29 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)985-995
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number6
DOIs
Publication statusPublished - Jun 1 2010

Fingerprint

Chronic Renal Insufficiency
Randomized Controlled Trials
Zinc
Confidence Intervals
Phosphodiesterase 5 Inhibitors
Therapeutics
Testosterone
Dialysis Solutions
Follicle Stimulating Hormone
MEDLINE
Registries
Placebos

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Treatment options for sexual dysfunction in patients with chronic kidney disease : A systematic review of randomized controlled trials. / Vecchio, Mariacristina; Navaneethan, Sankar D.; Johnson, David W.; Lucisano, Giuseppe; Graziano, Giusi; Querques, Marialuisa; Saglimbene, Valeria; Ruospo, Marinella; Bonifati, Carmen; Jannini, Emmanuele A.; Strippoli, Giovanni F M.

In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 6, 01.06.2010, p. 985-995.

Research output: Contribution to journalArticle

Vecchio, M, Navaneethan, SD, Johnson, DW, Lucisano, G, Graziano, G, Querques, M, Saglimbene, V, Ruospo, M, Bonifati, C, Jannini, EA & Strippoli, GFM 2010, 'Treatment options for sexual dysfunction in patients with chronic kidney disease: A systematic review of randomized controlled trials', Clinical Journal of the American Society of Nephrology, vol. 5, no. 6, pp. 985-995. https://doi.org/10.2215/CJN.09081209
Vecchio, Mariacristina ; Navaneethan, Sankar D. ; Johnson, David W. ; Lucisano, Giuseppe ; Graziano, Giusi ; Querques, Marialuisa ; Saglimbene, Valeria ; Ruospo, Marinella ; Bonifati, Carmen ; Jannini, Emmanuele A. ; Strippoli, Giovanni F M. / Treatment options for sexual dysfunction in patients with chronic kidney disease : A systematic review of randomized controlled trials. In: Clinical Journal of the American Society of Nephrology. 2010 ; Vol. 5, No. 6. pp. 985-995.
@article{9f0a53ae5cbc45e4b59aea119deae106,
title = "Treatment options for sexual dysfunction in patients with chronic kidney disease: A systematic review of randomized controlled trials",
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.",
author = "Mariacristina Vecchio and Navaneethan, {Sankar D.} and Johnson, {David W.} and Giuseppe Lucisano and Giusi Graziano and Marialuisa Querques and Valeria Saglimbene and Marinella Ruospo and Carmen Bonifati and Jannini, {Emmanuele A.} and Strippoli, {Giovanni F M}",
year = "2010",
month = "6",
day = "1",
doi = "10.2215/CJN.09081209",
language = "English",
volume = "5",
pages = "985--995",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "by the American Society of Nephrology",
number = "6",

}

TY - JOUR

T1 - Treatment options for sexual dysfunction in patients with chronic kidney disease

T2 - A systematic review of randomized controlled trials

AU - Vecchio, Mariacristina

AU - Navaneethan, Sankar D.

AU - Johnson, David W.

AU - Lucisano, Giuseppe

AU - Graziano, Giusi

AU - Querques, Marialuisa

AU - Saglimbene, Valeria

AU - Ruospo, Marinella

AU - Bonifati, Carmen

AU - Jannini, Emmanuele A.

AU - Strippoli, Giovanni F M

PY - 2010/6/1

Y1 - 2010/6/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=77953300124&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953300124&partnerID=8YFLogxK

U2 - 10.2215/CJN.09081209

DO - 10.2215/CJN.09081209

M3 - Article

C2 - 20498250

AN - SCOPUS:77953300124

VL - 5

SP - 985

EP - 995

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

IS - 6

ER -