Relationship between erectile dysfunction and asymmetric dimethyl arginine levels in patients with end-stage renal

Abstract

Objective: Asymmetric dimethylarginine is a major inhibitor of nitric oxide synthesis. Erectile dysfunction and chronic kidney disease (CKD) are associated with elevated levels of asymmetric dimethylarginine. This study aimed to examine the effects of ADMA on erectile dysfunction in patients undergoing peritoneal hemodialysis. Methods: A total of 32 peritoneal, 32 hemodialysis patients, and 32 healthy male volunteers were included in the study. Serum asymmetric dimethylarginine levels were measured, and clinical and laboratory parameters were analyzed. The International Index of Erectile Function-5 was used to evaluate sexual function and the Pittsburgh Sleep Quality Index was used to evaluate sleep quality. Depressive symptoms were assessed using the Beck depression inventory. Results: Asymmetric dimethylarginine levels differed significantly among the three groups (p<0.001). It was higher in patients undergoing hemodialysis than in those undergoing peritoneal dialysis (p <0.002). Erectile dysfunction was detected more frequently in the patient group than in the control group (p<0.001). However, correlation analysis revealed no significant relationship between asymmetric dimethylarginine levels and erectile dysfunction scores. There was a negative correlation between the erectile dysfunction score, sleep quality, and depression scale scores. Asymmetric dimethylarginine showed a significant positive correlation with treatment duration, phosphorus, calcium-phosphorous product, and parathormone. A negative correlation was observed between albumin, cholesterol, low-density lipoprotein (LDL), residual urine, and asymmetric dimethylarginine levels. Residual urine amount in the correlation analysis showed a negative correlation with asymmetric dimethylarginine, phosphorus, and calcium-phosphorus products and a positive correlation with total cholesterol and low-density lipoprotein. Conclusion: Residual renal function and urine amount are important parameters that correlate with ADMA levels for sustainable healthy erectile function in CKD.