Kidney Week

Abstract: SA-PO1069

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

Session Information

• Diet and Nutrition: Clinical
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

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

Praveen Kumar Potukuchi,

• Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Abduzhappar Gaipov,

• Sumida, Keiichi, Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan

Keiichi Sumida,

• Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Miklos Zsolt Molnar,

• Thomas, Fridtjof, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Fridtjof Thomas,

• Gatwood, Justin, University of Tennessee Health Science Center, Memphis, Tennessee, United States

Justin Gatwood,

• Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States

Elani Streja,

• Rhee, Connie, University of California Irvine, School of Medicine, Orange, California, United States

Connie Rhee,

• Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

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