Altunoglu A, Yavuz D, Canoz M Batur, Yavuz R, Karakaş Latife A, Bayraktar N, Colak T, Sezer S, Ozdemir F Nurhan, Haberal M
Nephrology Department, Baskent University Medical Faculty, Ankara, Turkey.
Nephrology Department, Baskent University Medical Faculty, Ankara, Turkey.
Transplant Proc. 2014 Jun;46(5):1585-90. doi: 10.1016/j.transproceed.2014.04.005.
Patients with end-stage renal disease (ESRD) experience female sexual dysfunction (FSD). The purpose of this study was to compare FSD in different types of renal replacement therapy and control patients.
The study was consisted of 47 renal transplantation (RT), 46 hemodialysis (HD), and 28 continuous ambulatory peritoneal dialysis (CAPD) patients and 36 healthy control subjects. All groups were evaluated with the following scales: Female Sexual Function Index (FSFI) questionnaire, Short Form (SF)-36 questionnaires, and Beck Depression Inventory (BDI). Demographic data, laboratory values, and hormone levels were obtained. The patients with FSFI score <26.55 were accepted as experiencing sexual dysfunction.
Overall, total FSFI scores in RT, HD, CAPD, and control were 22 (range, 2-35), 22.4 (4-34), 18.35 (2-34), and 29.6 (2-35), respectively. The mean total FSFI score was not different in patients receiving different kinds of renal replacement therapy (P > .05) although they were significantly worse then the control group (P < .001). On regression analysis, age was significantly associated with FSD (β = -0.14; P = .001). In addition, the physiologic health domain of SF-36 was significantly better in control groups (P < .001). The difference in terms of mean of BDI score did not reach statistical significance among patient groups (P > .05). Female sexual dysfunction score was negatively correlated with BDI (r = -0.371; P < .001) and positively correlated with the mental-physical components score of SF-36 (r = 0.423 [P < .001] and r = 0.494 [P < .001], respectively) in all patients groups. Regarding the hormones of the patients, there was a significant difference between RT and the HD and CAPD groups in dihydroepiandrosterone sulfate (DHEAS; P < .001), RT and HD in prolactin (P < .001), and RT and CAPD in free testesterone (P < .001).
Renal transplantation, hemodialysis, and peritoneal dialysis patients were at more risk of developing sexual dysfunction and lower quality of life scores than healthy subjects. Notably, the mode of renal replacement therapy had no impact on female sexual function.
终末期肾病（ESRD）患者存在女性性功能障碍（FSD）。本研究旨在比较不同类型肾脏替代治疗患者与对照患者的FSD情况。
本研究纳入47例肾移植（RT）患者、46例血液透析（HD）患者、28例持续性非卧床腹膜透析（CAPD）患者以及36例健康对照者。所有组均使用以下量表进行评估：女性性功能指数（FSFI）问卷、简明健康状况调查量表（SF-36）问卷以及贝克抑郁量表（BDI）。收集人口统计学数据、实验室检查值及激素水平。FSFI评分<26.55的患者被视为存在性功能障碍。
总体而言，RT组、HD组、CAPD组及对照组的FSFI总分分别为22分（范围2 - 35分）、22.4分（4 - 34分）、18.35分（2 - 34分）和29.6分（2 - 35分）。接受不同类型肾脏替代治疗的患者，其FSFI总分均值无差异（P > 0.05），但均显著低于对照组（P < 0.001）。回归分析显示，年龄与FSD显著相关（β = -0.14；P = 0.001）。此外，对照组SF-36的生理健康领域得分显著更高（P < 0.001）。患者组间BDI评分均值差异未达到统计学意义（P > 0.05）。在所有患者组中，女性性功能障碍评分与BDI呈负相关（r = -0.371；P < 0.001），与SF-36的生理心理综合评分呈正相关（分别为r = 0.423 [P < 0.001]和r = 0.494 [P < 0.001]）。关于患者的激素水平，RT组与HD组及CAPD组在硫酸脱氢表雄酮（DHEAS）方面存在显著差异（P < 0.001），RT组与HD组在催乳素方面存在显著差异（P < 0.001），RT组与CAPD组在游离睾酮方面存在显著差异（P < 0.001）。
与健康受试者相比，肾移植、血液透析及腹膜透析患者发生性功能障碍的风险更高，生活质量评分更低。值得注意 的是，肾脏替代治疗方式对女性性功能无影响。
