Sexual bother and sexual activity before and after kidney transplantation

Abstract

Among patients awaiting kidney transplantation (KT), sexual dysfunction is common due to end-stage kidney disease (ESKD) but may improve post-KT. Leveraging a two-center prospective study, 2,422 adult KT candidates and 490 adult KT recipients (5/2014-12/2023) were identified. Using the Kidney Disease Quality of Life Scale Short Form (KDQOL-SF), participants reported on the negative impact of sexual dysfunction due to ESKD (i.e., sexual bother) at KT evaluation, admission, and post-KT follow-ups. Using mixed effect logistic regression models, we estimated odds and trajectories for odds of sexual bother. At evaluation, 46.1% of male and 29.6% of female candidates reported sexual bother; 39.0% and 34.5%, respectively, had been sexually active in the past 4 weeks. At admission, 53.8% male and 27.0% female recipients reported sexual bother; 41.6% and 41.8%, respectively, had been sexually active in the past 4 weeks. The estimated prevalence of sexual bother decreased during the first 3 years post-KT (OR per year: 0.39, 95%CI: 0.25-0.60). Sexual activity increased and peaked 1-year post-KT. 3 years post-KT, 48.9% of male and 50.0% of female recipients were sexually active. Sexual bother is common pre-KT and improves post-KT, and sexual activity increases post-KT. Sexual health is important and should be considered during KT management.