Erectile dysfunction in chronic kidney disease

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Chronic kidney disease is the slow loss of kidney function over time, due to certain medical conditions and diseases that affect the kidney’s ability to perform its function. Kidneys are responsible for filtering waste from the blood into the urine to remove it from the system.

The main conditions that can impair the function of the kidney are

  • Kidney stones, obstructing the flow of urine from the kidneys
  • Diabetes mellitus type 1 and 2
  • High blood pressure

Kidney stones should be treated before they get to the point of obstructing outflow from the kidneys. Looking out for kidney stone symptoms and getting a diagnosis early on can help prevent chronic kidney disease from developing.

Managing your blood sugar levels and high blood pressure can also help stop the progression of chronic kidney disease.

What Causes ED in Kidney Disease?

 Most men with chronic kidney disease, also known as kidney failure face sexual problems due to a myriad of reasons, rather than just one reason.

  • Poor blood supply

For an erection to occur, the blood that enters should not leave the penis. However, many patients with kidney disease have narrow blood vessels all over their body, including those vessels that supply the penis. This reduces the blood supply to the penis and makes it difficult to get an erection. The narrowing of blood vessels can become even more exaggerated when the patient has diabetes or is elderly because ageing and diabetes both narrow the blood vessels as well.

  • Blood vessel leakage:

As mentioned above, an erection can only be maintained when blood that enters the penis doesn’t leave it. However, kidney disease causes blood vessels to leak, meaning that the blood that enters the penis will leak out of the penis, resulting in loss of erection.

  • Hormonal Imbalance

Kidney disease affects hormone levels in the body and if the hormone affected is testosterone, the male sex hormone, then an erection might be hard to maintain.

  • Medications

Certain medications used to treat chronic kidney disease can cause impotence and erectile dysfunction in men. As the use of these medications cannot be discontinued, erectile dysfunction treatment in this case requires the use of specific medications.

  • Nerve Damage

One of the common causes of chronic kidney disease is diabetes mellitus type 2, which damages the nerves in the body. Damage to the nerves innervating the penis can cause erectile dysfunction and other sexual disorders in patients.

  • Exhaustion

Chronic kidney disease can be difficult on the body and mind, with patients constantly tired. Tiredness and exhaustion can cause sexual dysfunction such as erectile dysfunction or impotence.

How to Diagnose ED in Chronic Kidney Disease?

Before erectile dysfunction can be diagnosed, there needs to be a discussion about the concern. Given the stigma around sexual disorders, most men do not feel comfortable raising the subject of erectile dysfunction. They are either in denial or scared of being judged and embarrassed.

Once the concern has been raised, an expert in sexual disorders needs to see the patient. Some hospitals have these specialists present in the kidney units. The specialist will perform a general check-up to get an idea about the extent to which kidney disease has progressed. Then a physical examination needs to be performed.

The specialist will also order a battery of tests to check the blood for hormonal imbalance and blood sugar levels, among other things. This will be followed by a review of medications being currently used as they could be the reason for erectile dysfunction.

This consultation is to analyse the cause of the condition so that appropriate treatment can be initiated.

Erectile Dysfunction Treatment

Accurate erectile dysfunction treatment requires accurate recognition of the cause. If the cause is nerve damage, then appropriate treatment for nerve damage needs to be applied. Treating for something else, in this case, might worsen the health of the patient or provide no erectile dysfunction treatment.

The treatment options are:

  • Hormone Injections

Treatment of erectile dysfunction that is caused by low testosterone levels, which in turn are caused by chronic kidney disease would require hormone injections. It is important to note that this treatment only works for men with kidney disease and low testosterone levels.

If there is a different type of hormonal imbalance, then appropriate medications need to be taken to correct the imbalance.

  • Viagra

Viagra is the medical treatment for all types of erectile dysfunction including that caused by chronic kidney disease. The medication is extremely effective, however, it interacts with many of the medications for kidney and heart disease.

To prevent the risk of severe side effects, it is recommended to discuss the interactions with your doctor and keep them in mind, if taking all medications together

  • Surgical solutions

Surgical solutions such as penile implants can help with erectile dysfunction treatment in kidney disease. However, kidney disease can alter the healing process and prolong it.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220354/
  2. https://www.frontiersin.org/articles/10.3389/fmed.2017.00032/full