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Submitted: 24 Aug 2021
Accepted: 09 Mar 2023
ePublished: 16 May 2023
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J Renal Inj Prev. 2023;12(3): e31952.
doi: 10.34172/jrip.2023.31952

Scopus ID: 85166310110
  Abstract View: 1116
  PDF Download: 1082

Original

Comparison of the efficacy of tadalafil in three different groups; patients on hemodialysis, first kidney transplant recipients, and second kidney transplant recipients

Mehdi Dehghani 1 ORCID logo, Amir-Hesam Alirezaei 2 ORCID logo, Amir Javid 1 ORCID logo, Nasrin Borumandnia 3 ORCID logo, Majid Aliasgari 3 ORCID logo, Farshad Gholipour 4* ORCID logo

1 Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
*Corresponding Author: Farshad Gholipour, Email: Gholipour@med.mui.ac.ir

Abstract

Introduction: The efficacy of phosphodiesterase-5 inhibitors (PDE5Is) on the improvement of erectile dysfunction (ED) in second kidney transplant (KT) recipients has not been studied before.

Objectives: We aimed to compare the efficacy of tadalafil in three groups: hemodialysis (HD) patients, first KT recipients (KT1) and second KT recipients (KT2) with bilaterally ligated internal iliac arteries (IIAs).

Patients and Methods: Age-matched men with ED were included in the study. Patients divided into three groups; HD, KT1 and KT2. The international index of erectile function 15 (IIEF-15) questionnaire was used to assess the baseline erectile function. Tadalafil was administered in a dose-escalation method for three months. Patients were reevaluated by the questionnaire at three months. The mean score evolution was compared between the study groups by Kruskal-Wallis H test.

Results: Total number of 106 patients in three groups was included in the final analysis. There was no significant difference between the study groups in terms of age, body mass index (BMI), blood pressure and frequency of smoking, opium, or alcohol use. Tadalafil was safe and effective in all three groups. The mean IIEF score evolution in HD, KT1 and KT2 groups was 16.4 (58.7% increase from baseline), 19.3 (45.0% increase) and 20.4 (52.7% increase), respectively.

Conclusion: Tadalafil is effective and safe in the management of ED even after the second kidney transplantation when the IIAs are cut bilaterally. The response rate is similar to first KT recipients and HD patients.

Trial Registration: The trial protocol was approved by the Thai Clinical Trials Registry (https://www.thaiclinicaltrials.org/show/TCTR20220310008, ethical code# IR.SBMU. UNRC.1396.43).


Implication for health policy/practice/research/medical education:

Second kidney transplant (KT) recipients with bilaterally ligated internal iliac arteries (IIAs) have lower erectile function scores than first KT recipients. In this age-matched non-randomized clinical trial, we compared the efficacy of tadalafil in three groups of hemodialysis (HD) patients, first KT recipients (KT1) and second KT recipients (KT2). The international index of erectile function 15 (IIEF-15) was conducted for assessment of efficacy. The results showed that tadalafil is effective in all three groups (around 45.0-58.7% increases from baseline scores). Thus, we recommend tadalafil for the treatment of erectile dysfunction even in second KT recipients.

Please cite this paper as: Dehghani M, Alirezaei AH, Javid A, Borumandnia N, Aliasgari M, Gholipour F. Comparison of the efficacy of tadalafil in three different groups; patients on hemodialysis, first kidney transplant recipients, and second kidney transplant recipients. J Renal Inj Prev. 2023; 12(3): e31952. doi: 10.34172/jrip.2023.31952.

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