Korean J Urol.  2015 Jan;56(1):76-81. 10.4111/kju.2015.56.1.76.

Association between renal function, erectile function and coronary artery disease: Detection with coronary angiography

• Canat L
• Canat M
• Guner B
• Gurbuz C
• Caskurlu T

• KMID: 2070272
• DOI: http://doi.org/10.4111/kju.2015.56.1.76

Abstract

PURPOSE
Many patients admitted for acute myocardial infarction (AMI) have chronic renal insufficiency and erectile dysfunction (ED). This study aimed to evaluate the relationship between ED and the glomerular filtration rate (GFR) in patients with coronary artery disease.
MATERIALS AND METHODS
We studied 183 patients undergoing coronary angiography owing to AMI. The GFR was calculated and the International Index of Erectile Function-5 (IIEF-5) was used to evaluate ED. The relations between erectile function, GFR, and the number of occluded coronary arteries were evaluated.
RESULTS
Of 183 patients with a mean age of 55.2+/-11.16 years who underwent coronary angiography owing to AMI, 100 (54.64%) had ED. The ED rate was 45.36% (44/97) in patients with single-vessel disease, 64.5% (31/48) in patients with two-vessel disease, and 65.7% (25/38) in patients with three-vessel disease. The ED rate in patients with single-vessel disease was significantly lower than in the other groups (p<0.001). The mean IIEF scores were 24.2+/-4.3, 20.4+/-4.9, and 20.5+/-4.2 in the three groups, respectively (p<0.001). Mean GFRs were similar in patients with single-vessel disease, two-vessel disease, and three-vessel disease (128.2+/-46.8, 130.8+/-70.9, and 110.8+/-44.6, respectively, p=0.171). The GFR was significantly lower in the presence of ED only for single-vessel disease (p=0.001).
CONCLUSIONS
This study confirmed that the presence and severity of ED are linked to the number of occluded vessels as documented by coronary angiography. The presence of ED and reduced GFR are associated with single-vessel coronary artery disease. This relationship can be used to predict the likelihood of coronary artery disease.

Keyword

Coronary artery disease; Erectile dysfunction; Glomerular filtration rate

MeSH Terms

Adult
Aged
*Coronary Angiography
Coronary Artery Disease/*radiography
Coronary Occlusion/*radiography
Erectile Dysfunction/*epidemiology
Glomerular Filtration Rate
Humans
Male
Middle Aged
Myocardial Infarction/*radiography
Renal Insufficiency, Chronic/*epidemiology
Risk Factors
Severity of Illness Index

Figure

• 

  Fig. 1 Relationship between International Index of Erectile Function-5 (IIEF-5) scores and number of occluded vessels. Group 1, single-vessel occlusion; group 2, two-vessel occlusion; group 3, three-vessel occlusion.

Reference

1. Lue TF. Erectile dysfunction. N Engl J Med. 2000; 342:1802–1813. PMID: 10853004.

2. Harriss LR, Ajani AE, Hunt D, Shaw J, Chambers B, Dewey H, et al. Accuracy of national mortality codes in identifying adjudicated cardiovascular deaths. Aust N Z J Public Health. 2011; 35:466–476. PMID: 21973254.

3. Laumann EO, Paik A, Rosen RC. The epidemiology of erectile dysfunction: results from the National Health and Social Life Survey. Int J Impot Res. 1999; 11(Suppl 1):S60–S64. PMID: 10554933.

4. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Tsekoura D, Vasiliadou C, et al. Arterial function and intimamedia thickness in hypertensive patients with erectile dysfunction. J Hypertens. 2008; 26:1829–1836. PMID: 18698219.

5. Yilmaz MI, Stenvinkel P, Sonmez A, Saglam M, Yaman H, Kilic S, et al. Vascular health, systemic inflammation and progressive reduction in kidney function; clinical determinants and impact on cardiovascular outcomes. Nephrol Dial Transplant. 2011; 26:3537–3543. PMID: 21378154.

6. Uren NG, Melin JA, De Bruyne B, Wijns W, Baudhuin T, Camici PG. Relation between myocardial blood flow and the severity of coronary-artery stenosis. N Engl J Med. 1994; 330:1782–1788. PMID: 8190154.

7. Turunc T, Deveci S, Guvel S, Peskircioglu L. The assessment of Turkish validation with 5 question version of ınternation index of erectile function (IIEF-5). Turkish J Urol. 2007; 33:45–49.

8. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999; 11:319–326. PMID: 10637462.

9. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16:31–41. PMID: 1244564.

10. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42:1206–1252. PMID: 14656957.

11. Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003; 44:360–364. PMID: 12932937.

12. El-Sakka AI, Morsy AM, Fagih BI, Nassar AH. Coronary artery risk factors in patients with erectile dysfunction. J Urol. 2004; 172:251–254. PMID: 15201787.

13. Billups KL, Bank AJ, Padma-Nathan H, Katz S, Williams R. Erectile dysfunction is a marker for cardiovascular disease: results of the minority health institute expert advisory panel. J Sex Med. 2005; 2:40–50. PMID: 16422903.

14. Pecoits-Filho R, Heimburger O, Barany P, Suliman M, Fehrman-Ekholm I, Lindholm B, et al. Associations between circulating inflammatory markers and residual renal function in CRF patients. Am J Kidney Dis. 2003; 41:1212–1218. PMID: 12776273.

15. El Barzouhi A, Elias-Smale S, Dehghan A, Vliegenthart-Proenca R, Oudkerk M, Hofman A, et al. Renal function is related to severity of coronary artery calcification in elderly persons: the Rotterdam study. PLoS One. 2011; 6:e16738. PMID: 21311747.

16. Nakano T, Ninomiya T, Sumiyoshi S, Fujii H, Doi Y, Hirakata H, et al. Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: the Hisayama study. Am J Kidney Dis. 2010; 55:21–30. PMID: 19765871.

17. Nakamura M, Yamashita T, Yajima J, Oikawa Y, Ogasawara K, Kirigaya H, et al. Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007. Hypertens Res. 2009; 32:920–926. PMID: 19696780.

18. Makarem AR, Karami MY, Zekavat OR. Erectile dysfunction among hemodialysis patients. Int Urol Nephrol. 2011; 43:117–123. PMID: 20535636.

19. Kopp RP, Dicks BM, Goldstein I, Mehrazin R, Silberstein JL, Colangelo CJ, et al. Does radical nephrectomy increase the risk of erectile dysfunction compared with partial nephrectomy? A cohort analysis. BJU Int. 2013; 111(3 Pt B):E98–E102. PMID: 22757628.

20. Bellinghieri G, Santoro D, Mallamace A, Savica V. Sexual dysfunction in chronic renal failure. J Nephrol. 2008; 21(Suppl 13):S113–S117. PMID: 18446743.

21. Messina LE, Claro JA, Nardozza A, Andrade E, Ortiz V, Srougi M. Erectile dysfunction in patients with chronic renal failure. Int Braz J Urol. 2007; 33:673–678. PMID: 17980064.

22. Solak Y, Akilli H, Atalay H, Kayrak M, Gok H, Turk S. The association of glomerular filtration rate and erectile dysfunction with severity of coronary artery disease in patients presenting with chest pain. Int Urol Nephrol. 2010; 42:765–771. PMID: 20039124.

23. Azadzoi KM, Goldstein I. Erectile dysfunction due to atherosclerotic vascular disease: the development of an animal model. J Urol. 1992; 147:1675–1681. PMID: 1593719.

24. Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart. 2003; 89:251–253. PMID: 12591819.

25. Abdel-Gawad M, Huynh H, Brock GB. Experimental chronic renal failure-associated erectile dysfunction: molecular alterations in nitric oxide synthase pathway and IGF-I system. Mol Urol. 1999; 3:117–125. PMID: 10851313.

26. Johnson D. Caring for Australians with Renal Impairment (CARI). The CARI guidelines: evaluation of renal function. Nephrology (Carlton). 2005; 10(Suppl 4):S133–S176. PMID: 16221118.