Impact of chronic kidney disease on sexual health: a survey of dialysis and transplant patients at Strasbourg University Hospital

Chronic kidney disease (CKD) significantly impairs patients’ quality of life, including their sexual health. For example, up to 75% of men on dialysis report erectile dysfunction and 30–80% of women with CKD experience sexual problems.1 Yet sexual health remains an under-discussed aspect of nephrology care.2 Multiple factors related to CKD and its management contribute to sexual dysfunction. Comorbid conditions such as diabetes and hypertension lead to vascular and neurological damage that can impair genital blood flow, erectile function, and sexual function.1 Moreover, certain treatments—including beta-blockers and calcineurin inhibitor immunosuppressants like cyclosporine—can further exacerbate sexual dysfunction.1,3 Endocrine disturbances in CKD, notably testosterone deficiency and hyperprolactin­emia, also contribute to reduced libido and erectile dysfunction.1 Additionally, the uremic milieu of advanced CKD, with the frequently associated anemia, may further diminish genital perfusion, compounding these issues.1 Beyond these factors, patients’ body image is often affected by the physical consequences of CKD and its treatment (eg, catheters, scars, edema), negatively influencing self-esteem and intimacy.4 Despite the clear importance of this issue, data on the sexual health of CKD patients remain scarce and this topic is seldom explored in routine practice.