Author/Editor		Vujkovac, Bojan; Vodopija, Nado; Lavre, Janez
Title		Sildenafil (Viagra) izboljša erektilno disfunkcijo pri dializnih bolnikih - naše prve izkušnje
Translated title		Use of sildenafil (Viagra) for erectile dysfunction in dialysis patients - our first experience
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. 1
Publication year		2002
Volume		str. 11-3
Language		slo
Abstract		Background. Male patients with end stage renal disease often report erectile dysfunction, which is very common especially in younger males. Impotence is reported to exceed 50% in male chronic renal failure patients, and is present in 65% of such patients undergoing hemodialysis. Numerous etiological factors have been reported as possible cause for sexual dysfunction. Sildenafil (Viagra), a potent specific inhibitor of cGMP phosphodiesterase, was used in this case study to improve erectile dysfunction in dialysis male patients. Methods and results. During 12 weeks we treated 4 dialysis patients. 2 patients were treated with peritoneal dialysis and 2 patients were in the program of chronic hemodialysis. All patients were in the program of dialysis for more than 24 months, and reported erectile dysfunction and impotence after they had started with dialysis treatment. Sildenafil was used in the treatment The dosage schedule for sildenafil was 50mg/ week orally for 2 weeks followed by 100 mg/week for the next 10 weeks if there was no effect on initial dosage. Efficacy of treatment was evaluated by means of the International lndex of Erectile Dysfunction. All 4 patients reported no significant effect on initial dose. With higher dose of sildenafil treatment was overwhelmingly successful, with reported prolonged improvement of erectile dysfunction for 42 to 72 hours. Side effects were present only in 1 patient who had severe headaches after higher dose. No patients experienced priapism. Conclusions. There have been only few reports in the literature on the use of sildenafil in dialysis patients. Our small case study suggests that sildenafil could be successfully and safely used for treatment of erectile dysfunction also in dialysis patients. A large trial would be necessary to confirm the efficacy of the drug for this specific group of patients.
Summary		Izhodišča. Erektilna disfunkcija je zelo pogosta pri moških s končno ledvično odpovedjo, ki so v programu nadomestnega zdravljenja s hemodializo ali peritonealno dializo (dializni bolniki), še posebej je to pogosta pri mlajših moških. Impotenca je prisotna pri več kot 5O% moških s kroničnim ledvičnim odpovedovanjem in 65% moških na hemodializi. Vzroki erektilne disfunkcije so lahko različne etiologije. V naši pilotski raziskavi smo za izboljšanje erektilne disfunkcije pri moških dializnih bolnikih uporabili sildenafil (Viagra), močan specifični inhibitor ciklične gvanozinmonofosfat (cGMP) fosfodiestraze. Metode in rezultati. V pilotski raziskavi smo štiri dializne bolnike zdravili 12 tednov. Dva sta v programu peritonealne dialize, dva pa v programu kronične hemodialize. Vsi bolniki so bili v programu nadomestnega dializnega zdravljenja več kot 24 mesecev in so anamnestično navajali občasen pojav impotence in erektilne disfunkcije po začetku dializnega zdravljenja. Za zdravljenje smo uporabili sildenafil v odmerku 50 mg enkrat tedensko per os za dva tedna, nato pa 100 mg enkrat tedensko 10 tednov, če po začetnem odmerku ni bilo učinka. Učinkovitost zdravljenja smo merili z Mednarodnim indeksom za erektilno disfunkcijo. Začetni odmerek zdravila ni bil učinkovit pri nobenem od bolnikov. Enkratni 100 mg odmerek zdravila pa je izboljšal erektilno disfunkcijo pri vseh štirih bolnikih za 48 do 72 ur. Le en bolnik je navajal glavobol kot stranski učinek po 100 mg odmerku. Pri nobenem bolniku se ni pojavil priapizem. Zaključki. Znanih je le nekaj poročil o uporabi sildenafila pri dializnih bolnikih. Naša pilotska raziskava je pokazala, da je sildenafil učnkovito zdravilo za zdravljenje erektilne disfunkcije tudi pri dializnih bolnikih. Potrebna bo večja randomizirana raziskava, ki bo potrdila varnost in učinkovitost zdravila tudi pri tej specifični skupini bolnikov.
Descriptors		HEMODIALYSIS PERITONEAL DIALYSIS, CONTINUOUS AMBULATORY IMPOTENCE PENILE ERECTION