Exploring the association between hemoglobin, hematocrit, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with erectile dysfunction in chronic kidney disease patients undergoing hemodialysis: a cross-sectional study

Erectile dysfunction (ED) is one of the complications in male patients with end-stage chronic kidney disease (CKD). Renal replacement therapy may improve general conditions and thus improve erectile function. This study aims to determine changes in erectile dysfunction in end-stage CKD patients who underwent hemodialysis, focusing on changes in laboratory parameters. This cross-sectional study was conducted from March to April 2024 at the Hemodialysis Unit of Wangaya General Hospital. The subjects were male patients with end-stage chronic kidney disease (CKD) who were undergoing hemodialysis and met the specific inclusion and exclusion criteria. Erectile function was assessed using the International Index of Erectile Function (IIEF- 5) and the Erection Hardness Score (EHS). Laboratory parameters, including hemoglobin, hematocrit, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were recorded. Twenty-two subjects were included in this study. The prevalence of ED before starting hemodialysis and after a period of at least 3 months of hemodialysis was 28.3% and 86.4% respectively. A statistically significant difference was observed in the IIEF-5 scores of patients before and after hemodialysis (p=0.001). Significant differences were observed in the erection degree before and after hemodialysis based on IIEF-5 (p=0.001) and EHS (p=0.001). There was a significant correlation between erection degree assessed by IIEF-5 and hemoglobin, hematocrit, NLR and PLR; and erection degree assessed by EHS and hemoglobin, hematocrit, and PLR, (all p<0.05). In conclusion, there is a deterioration in erectile function in patients undergoing hemodialysis compared to their condition before hemodialysis. There was a significant correlation between hemoglobin, hematocrit, NLR, and PLR and erectile dysfunction.