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Información de la revista
Vol. 34. Núm. 6.noviembre 2014
Páginas 693-810
Vol. 34. Núm. 6.noviembre 2014
Páginas 693-810
Acceso a texto completo
Disfunción sexual en pacientes en diálisis peritoneal: relación con factores metabólicos y con la percepción de la calidad de vida
Sexual dysfunction in men and women on peritoneal dialysis: Differential link with metabolic factors and quality of life perception
Visitas
19570
Pedro Azevedoa, Ricardo Santosb, José Durãesa, Olívia Santosc, Maria J. Carvalhoa, António Cabritaa, Anabela Rodriguesa
a Department of Nephrology and Renal Transplantation, Centro Hospitalar do Porto (CHP-HSA), Oporto, Portugal,
b Gynecology and Obstetrics Department, Centro Hospitalar do Alto Ave, Guimarães, Portugal,
c Department of Nephrology and Renal Transplantation, Centro Hospitalar do Porto (CHP-HSA),
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Introducción: La sexualidad, el estatus psicosocial y la calidad de vida (QoL) son factores importantes, a menudo infravalorados, en los esquemas de diálisis. Objetivos: Evaluar la prevalencia de disfunción sexual y sus asociaciones en los pacientes en diálisis peritoneal (DP). Métodos: Se utilizaron el Índice de Función Sexual Femenina (IFSF), el Índice Internacional de Función Eréctil (IIFE), la Escala de Ansiedad y Depresión Hospitalaria (HADS) y los cuestionarios sobre calidad de vida EQ5D en la población prevalente en DP (57 pacientes). Se realizaron análisis multivariantes para investigar los factores clínicos independientes para disfunción sexual. Resultados: Se diagnosticó disfunción sexual en el 67,9 % de las mujeres y en el 44,8 % de los varones. En las mujeres la albúmina sérica, la creatinina, los niveles de fósforo y EQ5D se relacionaran positivamente con IFSF. En los varones existía una correlación negativa entre el calcio sérico y el score IIEF. En el análisis multivariante los parámetros nutricionales permanecieron asociados de manera independiente con la disfunción sexual en mujeres; en los varones los principales determinantes fueron el aumento de la concentración de calcio y la disminución de la testosterona. En los análisis de regresión logística el riesgo de disfunción sexual en la población global está asociado a niveles menores de albúmina (OR = 6,94) y a un score inferior de EQ5D (OR = 6,93). Conclusiones: La disfunción sexual tiene una alta prevalencia y una fuerte asociación con la percepción de la calidad de vida de los pacientes en DP. Se han encontrado diferentes variables clínicas relacionadas con la disfunción sexual en cada sexo que justifican actitudes preventivas y terapéuticas individualizadas.

Palabras clave:
Disfunción sexual
Palabras clave:
Calidad de vida
Palabras clave:
Diálisis peritoneal

Background: Sexual function, psychosocial status and quality of life (QoL) are important dimensions, often underestimated, in dialysis treatment schedules. Objectives: The aim of this study was to evaluate the prevalence of sexual dysfunction and its associations, among peritoneal dialysis (PD) patients. Methods: The Index of Female Sexual Function (IFSF), the International Index of Erectile Function (IIEF), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life EQ5D questionnaires were applied to a prevalent PD population of 57 enrolled patients. Multivariate analysis was conducted to investigate clinical independent risk factors for sexual dysfunction. Results: Sexual dysfunction was diagnosed in 67.9% of women and 44.8% of men. In females, serum albumin, creatinine and phosphorus levels and EQ5D positively correlated with IFSF score. For males, there was a significant negative correlation between serum calcium levels and the IIEF score. On multivariate analysis, nutritional parameters remained independently associated with sexual dysfunction in women; in males, increase in calcium concentration and decrease of testosterone were main determinants. On logistic regression analysis, the risk of sexual dysfunction in global population was associated with lower values of albumin (OR=6.94) and with a lower QoL score EQ5D (OR=6.93). Conclusions: Sexual dysfunction is highly prevalent and strongly associated with impaired QoL of PD patients. Different clinical variables were related to sexual dysfunction in each gender, justifying an individualized preventive and therapeutic approaches.

Keywords:
Sexual dysfunction
Keywords:
Quality of life
Keywords:
Peritoneal dialysis
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Bibliografía
[1]
Lai C, Wang Y, Hung K, Peng YS, Lien YR, Wu MS, et al. Sexual dysfunction in peritoneal dialysis patients. Am J Nephrol 2007;27(6):615-21. [Pubmed]
[2]
Strippoli GF. Sexual dysfunction in women with ESRD requiring hemodialysis. Clin J Am Soc Nephrol 2012;7(6):974-81. [Pubmed]
[3]
Peng YS, Chiang CK, Kao TW, Hung KY, Lu CS, Chiang SS, et al. Sexual dysfunction in female hemodialysis patients: a multicenter study. Kidney Int 2005;68(2):760-5. [Pubmed]
[4]
Weisbord S. Sexual dysfunction and quality of life in patients on maintenance dialysis. Semin Dial 2013;26(3):278-80. [Pubmed]
[5]
Basok EK, Atsu N, Rifaioglu MM. Assessment of female sexual function and quality of life in predialysis, peritoneal dialysis, hemodialysis, and renal transplant patients. Int Urol Nephrol 2009;41(3):473-81. [Pubmed]
[6]
Rathi M, Ramachandran R. Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology. Indian J Endocrinol Metab 2012;16(2):214-9. [Pubmed]
[7]
Seidman SN, Roose SP, Menza MA. Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled trial with sildenafil citrate. Am J Psychiatry 2001;158(10):1623-30. [Pubmed]
[8]
Park HC, Lee H, Lee JP, Kim DK, Oh KH, Joo KW, et al. Lower residual renal function is a risk factor for depression and impaired health-related quality of life in Korean peritoneal dialysis patients. J Korean Med Sci 2012;27(1):64-71. [Pubmed]
[9]
Mahon A, Sidhu PS, Muir G, Macdougall IC. The efficacy of sildenafil for the treatment of erectile dysfunction in male peritoneal dialysis patients. Am J Kidney Dis 2005;45(2):381-7. [Pubmed]
[10]
Brooks R. EuroQol: the current state of play. Health Policy 1996;37(1):53-72. [Pubmed]
[11]
Rosas SE, Joffe M, Franklin E, Strom BL, Kotzker W, Brensinger C, et al. Association of decreased quality of life and erectile dysfunction in hemodialysis patients. Kidney Int 2003;64(1):232-8. [Pubmed]
[12]
Tsujimura A. The relationship between testosterone deficiency and men's health. World J Mens Health 2013;31(2):126-35. [Pubmed]
[13]
Michels WM, van Dijk S, Verduijn M, le Cessie S, Boeschoten EW, Dekker FW, et al. Quality of life in automated and continuous ambulatory peritoneal dialysis. Perit Dial Int 2011;31(2):138-47. [Pubmed]
[14]
Cukor D, Ver Halen N, Fruchter Y. Anxiety and quality of life in ESRD. Semin Dial 2013;26(3):265-8. [Pubmed]
[15]
Santos PR, Capote JR Jr, Cavalcanti JU. Sexual dysfunction predicts depression among women on hemodialysis. Int Urol Nephrol 2013;45(6):1741-6. [Pubmed]
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