The use of oral sildenafil citrate in hemodialysis patients: A multi-center double-blind placebo-controlled study

Abstract

Efficacy and safety of oral sildenafil citrate use in hemodialysis patients is not very well documented. We undertook a study to evaluate the efficacy and safety of oral sildenafil in treating erectile dysfunction in hemodialysis patients. A total of 50 male hemodialysis patients (mean age 49.2 years) with ED were recruited for this double- blind, placebo-controlled prospective study. Patients were randomized into two groups of 25 patients and received either a placebo or sildenafil. Patients in sildenafil group were started on a 50-mg dose, and the dose was increased to 100 mg if there was no response after 2 doses. Patients were asked to complete the International Index of Erectile Function (IIEF) and a global life-satisfaction questionnaire before and after each dose.Improvement was observed in 76% of the sildenafil patients compared with 12% of placebo patients using IIEF and global assessment questionnaire. Sildenafil was associated with improvement in the IIEF score in all domains except those related to sexual desire. Sildenafil use resulted in normal EF scores in 36% of sildenafil patients. No correlation was found between sildenafil failure and patient age, duration of ED and the duration and etiology of renal failure. Sildenafil was well tolerated. Side effects were rare but occurred equally in both groups.Conclusions: Sildenafil is a safe and satisfactory drug for improving erectile function in patients with ESRD without contraindications for this drug. Pretreatment scores on the IIEF may be useful in predicting the success of the treatment.