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Abstract: SA-PO1069

Association Between Pre-ESRD Phosphodiesterase Type 5 Inhibitors Use and Post-ESRD Mortality

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Sumida, Keiichi, Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Thomas, Fridtjof, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gatwood, Justin, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Rhee, Connie, University of California Irvine, School of Medicine, Orange, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background

Phosphodiesterase 5 inhibitors (PDE5i) are widely used to treat erectile dysfunction. Due to their vasodilatory properties, PDE5i may have systemic benefits, but information about the association between PDE5i and mortality in end-stage renal disease is lacking.

Methods

In a contemporary national cohort of 6,299 male US veterans with incident ESRD, we compared patients who received PDE5i treatment within 1 year prior to dialysis initiation to patients with a diagnosis of erectile dysfunction who did not receive PDE5i therapy. The association between PDE5i use (compared to non-use) and 1-year all-cause mortality after transition to ESRD were assessed using Cox proportional hazards models adjusted for sociodemographics, comorbidities, baseline vital parameters, and medication use.

Results

The mean age of the cohort was 65±10 years, 51% were white, 46% were African Americans, and 78% were diabetic. 2,212 (35%) patients received PDE5i treatment. PDE5i users displayed lower mortality than the non-users [Figure, unadjusted hazard ratio (95%CI): 0.80 (0.71-0.90, p<0.001)], but the survival advantage was attenuated after multivariable adjustments [0.93 (0.76-1.08, p=0.31)].

Conclusion

Pre-ESRD phosphodiesterase type 5 inhibitor use for erectile dysfunction was not associated with post-ESRD mortality. Further clinical studies are needed to study the effects of PDE5i use to determine its potential benefits in patients with ESRD.

Funding

  • NIDDK Support