Prevalence of Sexual Dysfunction in Nondialysis-Dependent CKD and Associated Factors

Background: Sexual dysfunction (SD) is a common but underrecognized complication in patients with chronic kidney disease (CKD), particularly in those who have not yet initiated kidney replacement therapy (KRT). While previous studies have reported a high prevalence of SD among CKD patients, data specific to Southeast Asia, including Thailand, remains limited. This study aims to determine the prevalence and risk factors of SD in non-dialysis CKD patients. Methods: A cross-sectional study was conducted in 3 hospitals. A total of 324 patients with CKD stages 1–5 who had not undergone KRT were enrolled. Sexual function was assessed using validated questionnaires: the International Index of Erectile Function (IIEF) for males and the Female Sexual Function Index (FSFI) for females. Baseline demographics, comorbidities, laboratory parameters, and medication history were analyzed. Univariate and multivariate logistic regression analyses were performed to determine significant risk factors for SD. Results: The prevalence of SD in non-dialysis CKD patients was 64.8%, with a higher prevalence in males (73.1%) compared to females (55.0%). Multivariate logistic regression analysis identified the following as significant independent risk factors for SD, Age >50 years (OR 3.41, 95%CI: 1.67–6.97, p = 0.001), advanced CKD stage: stage 4 (OR 6.60, 95%CI: 1.77–25.58, p = 0.005) and stage 5 (OR 9.13, 95%CI: 1.92–43.46, p < 0.001), Sulfonylurea use (OR 6.32, 95%CI: 1.22–32.84, p = 0.028). Other factors such as smoking, education level, hypertension, diabetes mellitus, HbA1C, and other medications did not reach statistical significance in the adjusted model. Conclusion: SD is highly prevalent in non-dialysis CKD patients, with older age, advanced CKD stages, and sulfonylurea use being the most significant independent predictors. These findings highlight the need for early screening and targeted interventions to improve sexual health and overall quality of life in CKD patients. Funding: Government Support – Non-U.S.