Prevalence of Sexual Dysfunction in Chronic Kidney Disease Patients Attending Renal Clinic at Kenyatta National Hospital

Abstract

Background: Sexual dysfunction (SD) is frequent but still underdiagnosed in chronic kidney disease (CKD) patients in Kenya. Moreover, the inconsistent usage of validated assessment (diagnostic) tools makes it problematic to define accurately the prevalence of SD. Objective: To assess the prevalence and correlates of SD in CKD patients. Design and Setting: A single centre cross-sectional study conducted between September 2019 and December 2019 at the Kenyatta National Hospital (KNH) Renal Clinic, Nairobi–Kenya. Methods: SD was assessed in 306 patients using abridged International Index of Erectile Function (IIEF-5), and Female Sexual Function Index (FSFI-6), a shortened form of the FSFI-19 that all assess sexual function over the past month. Lower scores represented SD. Correlates of SD was identified in an aged and employment status adjusted Poisson model with a robust variance estimator. Results: Of all the 306 patients, SD was reported in 81.4%. The prevalence of erectile dysfunction (ED) and female sexual dysfunction (FSD) was 88.9% (136/153) and 73.9% (113/153), respectively. The correlates of increased risk of ED were as follows: males with history of a cardiovascular event [adjusted risk ratio (adj. RR) = 1.12, confidence interval (CI): 1.01, 1.25, p <0.01], use of beta-blocker (adj. RR = 1.15, CI: 1.05, 1.26, p<0.001), angiotensin receptor blocker (adj. RR = 1.12, CI: 1.0, 1.26, p<0.01), and lipid-lowering therapy (adj. RR = 1.13, CI: 1.01, 1.27, p<0.01). For the females, former smokers had 33% increased risk of FSD (adj. RR = 1.33, CI: 1.11, 1.6, p<0.01) than never smokers. Female patients with endocrine dysfunction comorbidity had 14% increased risk of SD (adj. RR = 1.14, CI: 1.04, 1.26, p<0.01), those taking angiotensin receptor blocker had 52% increased risk (adj. RR = 1.52, CI: 1.25, 1.86, p<0.001) while those taking antipsychotics had 49% increased risk of SD (adj. RR = 1.49, CI: 1.25, 1.78, p<0.001). Conclusions: SD in both males and females was highly prevalent in CKD patients. Given the correlates of increased risk of SD, the results showed that there is an unmet need for interventions to manage it. Patients being treated or managed for CKD should, therefore, be routinely screened for SD using validated psychometric instruments.