The Effect of Renal Transplant on Hypogonadism and Erectile Dysfunction due to End-stage Renal Disease

Abstract

Hypogonadism is common in patients with chronic kidney disease especially for end-stage renal disease (ESRD), which is referred to as uremic hypogonadism. Men with ESRD are prone to reproductive and sexual disorders such as sexual desire loss, abnormalities in orgasm, sexual dysfunction, and erectile dysfunction (ED). The mechanism of this complex disorder is not well known. Considering the above, we decided to study the effect of renal transplantation on hypogonadism and sexual activity in patients with ESRD. This study was performed on 45 patients with ESRD undergoing renal transplantation. Patients were included into two groups of live donor (24) and cadaveric (21), according to the type of kidney donors. The International Index of Erectile Function-5 (IIEF5) questionnaire was filled out for evaluation of erectile and sexual status. Laboratory parameters were assessed before the renal transplant in a single and valid laboratory including blood urea nitrogen, creatinine, thyroid function tests, luteinizing hormone, follicle-stimulating hormone, testosterone, and prolactin. We refilled the ED questionnaire and checked the laboratory tests again three and six months after transplantation. The mean age of the patients was 51.7 ± 8.0. The mean blood testosterone level in the live group was 347.1 ± 64.9 before transplantation, which reached 413.1 ± 25.9 in six months after transplantation. The same variable for the cadaveric group was 306 ± 56.2 and 355.3 ± 56.9, respectively. The IIEF5 scores before and six months after transplantation were 17.2 ± 4.5 and 24.6 ± 3.3 respectively for the live group and 10.8 ± 2.4 and 13.9% ± 4.1% for the cadaveric one, all of which were statistically significant. Renal transplantation significantly improves the condition of hypogonadism and ED in patients with ESRD. This improvement is not related to the type of donation.