Incidence and Severity of Erectile Dysfunction in Chronic Kidney Disease Patients Undergoing CAPD and Hemodialysis: A Systematic Review and Meta-analysis

Background: Erectile dysfunction (ED) is an adverse effect of chronic kidney disease (CKD) treatment that can reduce patients’ quality of  life. Consequently, the purpose of this study is to assess the incidence and severity of ED in CKD patients who have undergone continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Methods: We performed a systematic search on several electronic  reference databases (PubMed, ScienceDirect, Web of Science, and Cochrane). Inclusion criteria are articles published in English, full-text  availability, and articles published between 2001 and 2023. The reviewed studies were observational studies. The studies analyzed either CAPD or hemodialysis. Results: A total of 15 studies were included. ED in patients with CKD who had undergone CAPD and hemodialysis  varied, ranging from 51.84% to 80.5%and 56% to 89%, respectively. A pooled estimate showed that CKD patients who underwent  hemodialysis had higher odds of developing ED (odds ratio [OR]=12.56; 95% confidence interval [CI]=6.37–24.77; p<0.001) compared with  those who underwent CAPD (OR=8.02; 95%CI=1.64–39.15; p=0.01). Regarding the laboratory outcomes, no significant differences were  found in creatinine serum (MD= −1.08; 95%CI= −3.21 to 1.06; p=0.32) and hemoglobin levels (MD= −0.38; 95%CI= −1.05 to 0.30; p=0.27)  between CKD patients who underwent dialysis, either with or without ED. Conclusion: ED is prevalent among patients undergoing  hemodialysis. In addition, hemodialyzed patients exhibited more severe levels of ED compared with CAPD patients. Therefore, we suggest  CAPD for CKD patients with ED.