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NDT Advance Access published online on February 1, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl755
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Sexual dysfunction in dialysis patients treated with antihypertensive or antidepressive medications: results from the DOPPS

George R Bailie1,2, Stacey J Elder3, Nancy A Mason4, Yasushi Asano5, Jose M Cruz6, Shunichi Fukuhara7, Antonio A Lopes8, Donna L Mapes3, David C Mendelssohn9, Juergen Bommer10 and Eric W Young11

1Albany College of Pharmacy, 2Albany Nephrology Pharmacy (ANephRx), Albany, NY, 3Arbor Research Collaborative for Health, 4College of Pharmacy, University of Michigan, Ann Arbor, MI, USA, 5Department of Internal Medicine, Koga Redcross Hospital, Ibaraki, Japan, 6Division of Nephrology, Hospital General University ‘La Fe’, Valencia, Spain, 7Health Care Research, Kyoto University, Kyoto, Japan, 8Internal Medicine, Federal University of Bahia, Bahia, Brazil, 9Internal Medicine, Humber River Hospital/University of Toronto, Weston, Ontario, Canada, 10University of Heidelberg, Heidelberg, Germany, 11Internal Medicine, Veterans Affairs Medical Center/University of Michigan, Ann Arbor, MI, USA

Correspondence and offprint requests to: George R. Bailie, Professor of Pharmacy, Albany Nephrology Pharmacy (ANephRx) Group, Albany College of Pharmacy, 106 New Scotland Avenue, Albany, NY 12208, USA. Email: bailieg{at}acp.edu



  Abstract

Background. The relationship between medication prescription and sexual dysfunction (SD) in dialysis patients is unclear.

Methods. We studied antihypertensive and antidepressive agents prescribed for 7346 patients in the Dialysis Outcomes and Practice Patterns Study phase 1 (DOPPS I) and 8891 patients in DOPPS II. At baseline, DOPPS I patients completed a quality of life survey, including four questions about sexual functioning, from which we created a composite SD scale. DOPPS II patients were asked only one question about SD. We examined predictors of SD with logistic regression, using numerous patient characteristics, comorbid conditions and additional variables.

Results. Reported SD ranged from 66.4% (France) to 84.5% (Spain). The mean composite SD score ranged from 6.4 (Spain) to 7.9 (Germany) (on a 3–15 scale). Peripheral {alpha}-blockers increased odds of DOPPS I patients having their sex life bothered by end-stage renal disease (ESRD) (OR = 1.18), and there were elevated odds of arousal problems with central antagonists, loop diuretics and peripheral {alpha}-blockers (OR = 1.19, 1.24 and 1.29, respectively). Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines increased odds of problems with enjoyment (OR = 1.59 and 1.26, respectively) and arousal (OR = 1.70 and 1.24, respectively), and having sex life bothered by ESRD (DOPPS I: OR = 1.36 and 1.24; DOPPS II: 1.30 and 1.31, respectively). Vasodilators reduced the odds of sexual enjoyment problems (OR = 0.75). Composite SD scores worsened with peripheral {alpha}-blockers (+0.41), tricyclics (+0.78), SSRIs (+0.80) and benzodiazepines (+0.50), but not with vasodilators (–0.57).

Conclusions. Awareness of associations between SD and prescribed medications may offer opportunities for intervention.

Keywords: antidepressives; antihypertensive agents; haemodialysis; medication-related; sexual dysfunction


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