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Abstract: TH-PO321

Acceptance of Erectile Dysfunction Treatment by Patients on Hemodialysis and Their Renal Providers

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Puli, Amoghavarsha, University of Pittsburgh Medical Center, PIttsburgh, Pennsylvania, United States
  • Abdalla, Hossam, University of Pittsburgh Medical Center, PIttsburgh, Pennsylvania, United States
  • Weisbord, Steven D., University of Pittsburgh Medical Center, PIttsburgh, Pennsylvania, United States

Erectile Dysfunction (ED) is highly prevalent in men receiving chronic hemodialysis (HD). Past studies demonstrate that treatment of ED with phosphodiesterase-5 inhibitors is safe and effective in this population. However, it is unknown whether these medications and other therapies are routinely used. We sought to investigate the acceptance of treatment for ED among men on chronic HD and their renal providers.


As part of a clinical trial of symptom management in patients on chronic hemodialysis, we assessed erectile dysfunction monthly using the Sexual Health Inventory of Men (SHIM) tool. For men with erectile dysfunction (SHIM score < 22), trained research nurses provided treatment recommendations and if patients and providers accepted them, helped facilitate their implementation. We assessed patients’ acceptance of recommendations, reasons for refusal, and providers implementation of therapy. All data was analyzed at the level of monthly assessments.


Of the 101 patients followed for up to 12 months, 46 of 47 (98%) men met criteria for erectile dysfunction. These 46 patients reported ED on 426 monthly assessments. In 49 of the 426 (11.5%) assessments, patients accepted the recommendation for treatment. On 59 assessments (14%) patients were already on treatment or had received a prescription. On 11 monthly assessments (2.5%) patients reported having financial obstacles precluding treatment. On 260 (61%) monthly assessments, patients refused the treatment recommendations. The primary reason patients refused the recommendations was no desire to discuss treatment options (53%) and not interested in being sexually active or not having a partner (38%). In 14 of the 27 assessments (51%) where patients accepted the recommendation, renal providers were unwilling to provide treatment.


Despite the high prevalence of ED in the hemodialysis population, a large majority of patients are not interested in pursuing treatment. For patients interested in treatment, renal providers are commonly unwilling to modify or initiate therapy. Future efforts should focus on identifying patients interested in treatment and improving the provision of therapy for these individuals.


  • Veterans Affairs Support