Interventions for treating sexual dysfunction in patients with chronic kidney disease

Mariacristina Vecchio; Sankar D Navaneethan; David W Johnson; Giuseppe Lucisano; Giusi Graziano; Valeria Saglimbene; Marinella Ruospo; Marialuisa Querques; Emmanuele A Jannini; Giovanni FM Strippoli

doi:10.1002/14651858.CD007747.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Guías
Temas

Revisiones y protocolos relacionados

Topics

Temas

Figure 1

Flow chart showing the number of citations retrieved by individual searches and number of studies included

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 PDE inhibitors versus placebo, Outcome 1 Sexual function using IIEF‐5.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 PDE inhibitors versus placebo, Outcome 2 Sexual function using IIEF‐15.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 PDE inhibitors versus placebo, Outcome 3 Headache.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 PDE inhibitors versus placebo, Outcome 4 Improvement in erectile function.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Zinc versus placebo, Outcome 1 Serum testosterone.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Zinc versus placebo, Outcome 2 Improvement of libido.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Zinc versus placebo, Outcome 3 Plasma FSH.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Zinc versus placebo, Outcome 4 Plasma LH.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 Zinc versus placebo, Outcome 5 Frequency of intercourse.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 Zinc versus placebo, Outcome 6 Total/partial impotence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 Zinc versus placebo, Outcome 7 Variations in libido.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 Zinc versus placebo, Outcome 8 Nocturnal penile tumescence (NPT).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Vitamin E versus placebo, Outcome 1 Prolactin.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Vitamin E versus placebo, Outcome 2 Plasma LH.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Vitamin E versus placebo, Outcome 3 Plasma FSH.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 Vitamin E versus placebo, Outcome 4 Serum testosterone.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. Other outcomes related to sexual dysfunction as reported in the included studies

Study ID	N	Intervention	Outcome	Mean ± SD (treatment group or baseline value) or RR (95% CI)	Mean ± SD (control group or after treatment)
Antoniou 1977	8	Oral zinc versus placebo	Testosterone concentration (ng/mL)¹	8.00 ± 3.50	3.20 ± 2.00
			LH (mU/mL)¹	85.30 ± 81.00	47.30 ± 26.90
			FSH (mU/mL)¹	24.00 ± 24.30	33.00 ± 8.70
Bellovich 2000	14	Sildenafil citrate	IIEF ‐ Frequency of penetration	3.85 ± 3.10	4.43 ± 2.92
Bellovich 2000	14	Sildenafil citrate	IIEF ‐ Maintenance of erection penetration	4.43 ± 2.69	4.93 ± 2.32
Brook 1980	14	Zinc chloride versus placebo to dialysate	Improvement of libido	1.00 (0.08 to 13.02)	NA
Brook 1980	14	Zinc chloride versus placebo to dialysate	Plasma testosterone (nmol/L)²	9.00 ± 4.23	12.00 ± 1.32
Mahajan 1982	20	Oral zinc acetate versus placebo	Total/partial impotence	0.13 (0.02 to 0.82)	NA
			Decreased libido	0.11 (0.01 to 1.83)	NA
			Decreased frequency of intercourse	0.22 (0.06 to 0.78)	NA
			Increased plasma testosterone³	5.20 ± 1.58	3.00 ± 0.95
			Decreased plasma FSH³	25.00 ± 22.14	35.00 ± 15.81
			Decreased plasma LH³	49.00 ± 82.22	38.00 ± 25.3
Mahon 2005	13	Sildenafil citrate versus placebo	Global efficacy question	2.50 (1.05 to 5.96)	NA
Muir 1983	14	Bromocriptine versus placebo	Testosterone (nmol/L)¹	16.80 ± 4.49	17.00 ± 4.11
Sharma 2006	32	Sildenafil citrate versus placebo	Global efficacy question	4.33 (2.07 to 9.08)
			Blood urea nitrogen (mg/dL)²	18.3 ± 7.6	17.9 ± 51.0
			Creatinine (mg/dL)²	1.48 ± 0.4	1.4 ± 0.4
			Haemoglobin (g/dL)²	12.3 ± 1.5	13.2 ± 1.4
Wabrek 1982	8	Oral zinc versus placebo	Tumescence episodes	0.75 (0.07 to 7.73)	NA
Yeksan 1992	24	Vitamin E versus placebo*	Prolactin (ng/mL)	15.00 ± 4.28	56.23 ± 15.66
			LH (mU/mL)	4.66 ± 1.80	11.43 ± 5.70
			FSH (mU/mL)	4.23 ± 1.83	4.88 ± 2.94
			Testosterone (pg/mL)	11.79 ± 4.16	4.79 ± 1.82
¹ significance not reported; ² P value not significant; ³ P value < 0.05; * Data pre and post vitamin E treatment only is reported; IIEF ‐ International Index of Erectile Function; LH ‐ luteinizing hormone; FSH ‐ follicular stimulating hormone; SD ‐ standard deviation; RR ‐ relative risk; NA ‐ not applicable or not available.

Table 1. Other outcomes related to sexual dysfunction as reported in the included studies

Ir a la tabla de la revisión

Comparison 1. PDE inhibitors versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Sexual function using IIEF‐5 Show forest plot	4		Mean Difference (IV, Random, 95% CI)	Subtotals only

1.1 Total score	2	101	Mean Difference (IV, Random, 95% CI)	10.65 [5.34, 15.96]
1.2 Erection frequency	3	149	Mean Difference (IV, Random, 95% CI)	1.54 [1.14, 1.93]
1.3 Erection quality (Q2)	3	165	Mean Difference (IV, Random, 95% CI)	1.78 [1.04, 2.53]
1.4 Penetration ability (Q3)	3	165	Mean Difference (IV, Random, 95% CI)	1.70 [1.16, 2.24]
1.5 Maintenance frequency of penetration (Q4)	4	193	Mean Difference (IV, Random, 95% CI)	1.60 [1.02, 2.18]
1.6 Maintenance of erection after penetration (Q5)	4	193	Mean Difference (IV, Random, 95% CI)	1.83 [1.17, 2.50]
1.7 Erection confidence (Q15)	3	165	Mean Difference (IV, Random, 95% CI)	1.39 [0.84, 1.95]
2 Sexual function using IIEF‐15 Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

2.1 Overall satisfaction	1	41	Mean Difference (IV, Random, 95% CI)	2.64 [1.32, 3.96]
2.2 Erectile function	2	80	Mean Difference (IV, Random, 95% CI)	10.64 [5.32, 15.96]
2.3 Orgasmic function	1	41	Mean Difference (IV, Random, 95% CI)	1.70 [0.35, 3.05]
2.4 Intercourse satisfaction	1	41	Mean Difference (IV, Random, 95% CI)	1.71 [0.11, 3.31]
2.5 Sexual desire	1	41	Mean Difference (IV, Random, 95% CI)	0.49 [‐0.67, 1.65]
3 Headache Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

4 Improvement in erectile function Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 1. PDE inhibitors versus placebo

Ir a la tabla de la revisión

Comparison 2. Zinc versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Serum testosterone Show forest plot	3	42	Std. Mean Difference (IV, Random, 95% CI)	0.70 [‐1.05, 2.45]

1.1 Zinc in dialysate	2	22	Std. Mean Difference (IV, Random, 95% CI)	0.21 [‐2.14, 2.55]
1.2 Oral zinc	1	20	Std. Mean Difference (IV, Random, 95% CI)	1.62 [0.58, 2.66]
2 Improvement of libido Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

3 Plasma FSH Show forest plot	2	28	Mean Difference (IV, Random, 95% CI)	‐9.69 [‐23.72, 4.34]

4 Plasma LH Show forest plot	2	28	Mean Difference (IV, Random, 95% CI)	18.80 [‐26.16, 63.76]

5 Frequency of intercourse Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

6 Total/partial impotence Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

7 Variations in libido Show forest plot	2	34	Risk Ratio (M‐H, Random, 95% CI)	0.11 [0.01, 1.83]

8 Nocturnal penile tumescence (NPT) Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 2. Zinc versus placebo

Ir a la tabla de la revisión

Comparison 3. Vitamin E versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Prolactin Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

2 Plasma LH Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

3 Plasma FSH Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

4 Serum testosterone Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 3. Vitamin E versus placebo

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet