Prevalence and Drivers of Erectile Dysfunction in CKD

Background Erectile dysfunction (ED) is an underrecognized complication in males with chronic kidney disease (CKD), significantly impacting quality of life. This study aimed to investigate the prevalence and drivers of ED in patients with CKD. Materials and Methods A cross-sectional study was conducted among 100 non-dialysis male CKD patients (aged 25-50 years) stratified by CKD stage (I-V). ED was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Demographic, clinical, and laboratory data were analyzed using correlation heatmaps, simple linear regression, and multivariable stepwise regression to identify predictors of ED. Results The overall ED prevalence was 55%, escalating with CKD severity: 60% in stages I-II, 76% in stage III, and 96% in stages IV-V. Severe ED was absent in early stages but affected 40% of advanced CKD patients. Hypoalbuminemia emerged as the strongest modifiable predictor (β = 0.51, p < 0.001), accounting for 40% of the variance in ED. Each 1 g/dL increase in albumin resulted in a 3.2-point improvement in IIEF-5 scores. Non-modifiable factors like albumin-to-creatinine ratio (ACR; β = −0.28, p = 0.006) and age (β = −0.25, p = 0.018) further exacerbated ED risk. Renal function markers (eGFR, serum creatinine) and comorbidities (hypertension, diabetes) also correlated significantly with ED severity. Conclusion ED is highly prevalent in CKD and worsens with disease progression. Hypoalbuminemia, reflecting malnutrition-inflammation pathways, is the dominant modifiable risk factor, while ACR and age are also associated with ED.