Sexual dysfunction in hemodialysis patients: Prevalence and risk factors in Morocco

Jaouad Chouikh, Saloua Ait El Haj, Nezha Nacer, Hicham Mejdouli, Nadia Ouzennou


This research was designed to investigate the prevalence and risk factors associated with sexual dysfunction in women with chronic renal failure on hemodialysis in the Marrakech-Safi region of Morocco. A questionnaire was distributed to 225 sexually active married CKD patients undergoing hemodialysis. Their results were compared with those of 120 healthy, sexually active married women matched for age and socioeconomic class. The present study showed that 76.4% of the women had sexual dysfunction. The total sexual function scores of hemodialysis patients (19.44 ± 6.3) were significantly lower than those of the control group (27.42 ± 4.8; p < 0.001). Sexual dysfunction was influenced by age (OR = 2.721; CI 2.168–3.745; p<0.001), etiology of chronic renal failure (OR = 4.645; CI 2.783–7.286; p 0.001), biological data (OR = 5,837; CI 5,112–9,371; p<0.001), associated co-morbidity (OR = 2,193; CI 1,424–3,412; p 0.01), and months of dialysis duration (OR = 3,345; CI 1,215–10,573; p<0.05). This study revealed a significant prevalence of sexual dysfunction, and more effort in diagnosis and management should be made. (Afr J Reprod Health 2023; 27 [10]: 115-122).

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Mota RL, Fonseca R, Santos JC, Covita AM, Marques N,

Matias P, Simoes H, Ramos C, Machado D and

Cardos J. Sexual Dysfunction and Satisfaction in

Kidney Transplant Patients. The Journal of Sexual

Medicine. 2019;16(7):1018-1028.


Eckardt KU, Coresh J, Coresh J, Devuyst O, Johnson RJ,

Kottgen A, Levey AS and Levin A. Evolving

importance of kidney disease: from subspecialty to

global health burden. The Lancet.

;382(9887):158-169. doi:10.1016/S0140-


Benghanem Gharbi M, Elseviers M, Zamd M, Belghiti Alaoui

A, Benhadi N, Trabelssi EH, Bayahia R, Ramdani B

and De Broe M. Chronic kidney disease,

hypertension, diabetes, and obesity in the adult

population of Morocco: how to avoid “over”- and

“under”-diagnosis of CKD. Kidney International.



Rothrock NE, Hays RD, Spritzer K, Yount SE, Riley W and

Cella D. Relative to the general US population,

chronic diseases are associated with poorer healthrelated quality of life as measured by the PatientReported Outcomes Measurement Information

System (PROMIS). Journal of Clinical Epidemiology.



Aribi L, Masmoudi R, Ben Houidi A, Charfeddine F, Jarraya

F and Amami O. Sexual disorder in hemodialysis

patients. La Tunisie medicale. 2015;93:79-84.

Agarwal KA and Pavlakis M. Sexuality, Contraception, and

Pregnancy in Kidney Transplantation. Kidney

Medicine. 2021;3(5):837-847.


Pertuz W, Castaneda DA, Rincon O and Lozano E. Sexual

Dysfunction in Patients With Chronic Renal Disease:

Does It Improve With Renal Transplantation?

Transplantation Proceedings. 2014;46(9):3021-3026.


Van Ek GF, Krouwel EM, Nicolai MP, Bouwsma H, Ringers

J, Putter, Pelger RCM and Elzevier HW. Discussing

Sexual Dysfunction with Chronic Kidney Disease

Patients: Practice Patterns in the Office of the

Nephrologist. The Journal of Sexual Medicine.

;12(12):2350-2363. doi:10.1111/jsm.13062

Diemont WL, Vruggink PA, Meuleman EJH, Doesburg WH,

Lemmens WAJG and Berden JHM. Sexual

dysfunction after renal replacement therapy.

American Journal of Kidney Diseases.

;35(5):845-851. doi:10.1016/S0272-


Wang CJ, Cukor D and Johansen KL. Sexual Dysfunction

Among Patients With Chronic Kidney Disease.

Seminars in Nephrology. 2021;41(6):534-549.


Strippoli GFM. Sexual Dysfunction in Women with ESRD

Requiring Hemodialysis. Clin J Am Soc Nephrol.

;7(6):974-981. doi:10.2215/CJN.12601211

Navaneethan SD, Vecchio M, Johnson DW, Chem P, Johson

DW, Saglimbene V, Graziano G, Pellegrini F,

Lucisano, Craig JC, Ruospo M, Biol M, Gentile G,

Manfreda VM, Querques M, Stroumza P, Torok M,

Celia, Gelfman R, Ferrari JN, Skublewska AB, Dulwa

J, Bonifati C and Strippoli G. Prevalence and

Correlates of Self-Reported Sexual Dysfunction in

CKD: A Meta-analysis of Observational Studies.

American Journal of Kidney Diseases.

;56(4):670-685. doi:10.1053/j.ajkd.2010.06.016

Merkus MP, Jager KJ, Dekker FW, Boeschoten EW, Stevens

P and Krediet RT. Quality of life in patients on chronic

dialysis: Self-assessment 3 months after the start of

treatment. American Journal of Kidney Diseases.

;29(4):584-592. doi:10.1016/S0272-


Yazici R, Altintepe L, Guney I, Yeksan, Atlay H, Turc S,

Tonbul HZ and Selcuk NY. Female Sexual

Dysfunction in Peritoneal Dialysis and Hemodialysis

Patients. Renal Failure. 2009;31(5):360-364.


Peng YS, Chiang CK, Kao TW, Hung KY, Lu CS, Chiang

SS, Yang CS, Huang YC, Wu KD, Lien YR, Yang

CC, Tsai DM, Chen PY, Liao CS and Tsai TJ. Sexual

dysfunction in female hemodialysis patients: A

multicenter study. Kidney International.

;68(2):760-765. doi:10.1016/S0085-


Ministère de l’Intérieur, Direction Générale des Collectivités


MARRAKECH-SAFI. Published 2023. Accessed

July 18, 2023.

Nacer N, Fatimi N, Rkha S and Ouzennou N. Syndromes

associated with sexually transmitted infections:

Prevalence and risk factors among women of

childbearing age in Morocco. African Journal of

Reproductive Health. 2022;26(9). Accessed October 17, 2022.

Kettaş E, Çayan F, Akbay E, Kıykım A and Çayan S. Sexual

Dysfunction and Associated Risk Factors in Women

with End-Stage Renal Disease. The Journal of Sexual

Medicine. 2008;5(4):872-877. doi:10.1111/j.1743-


Shaeer O, Shaeer K and Shaeer E. The Global Online

Sexuality Survey (GOSS): Female Sexual

Dysfunction among Internet Users in the

Reproductive Age Group in the Middle East. The

Journal of Sexual Medicine. 2012;9(2):411-424.


Witting K, Santtila P, Varjonen M, Jern P, Johansson A and

Pahlen BVD, Sandnabba K. Couples’ sexual

dysfunctions: Female Sexual Dysfunction, Sexual

Distress, and Compatibility with Partner. The Journal

of Sexual Medicine. 2008;5(11):2587-2599.


Kharbach Y, Bourouhou H, Tenkorang S, Mellas S, EL

Ammari JE, Tazi MF, Khalouk A, El Fassi MJ, Sqalli

Housaini T and Farih MH. Correlations between

sexual dysfunction and the clinicobiological profile of

renal failure patients on hemodialysis. African

Journal of Urology. 2016;22(4):310-314.


Grover S, Shah R, Dutt A and Avasthi A. Prevalence and

pattern of sexual dysfunction in married females

receiving antidepressants: An exploratory study -

PubMed. Published 2012. Accessed July 19, 2023.

Yilmaz FA, Avci D, Aba YA, Ozdilek R and Dutucu N.

Sexual Dysfunction in Postpartum Turkish Women:

It’s Relationship with Depression and Some Risk

Factors. African Journal of Reproductive Health.

;22(4):54-63. doi:10.4314/ajrh.v22i4

Elshimi E, Morad W, Mohamad NE, Shebl N and Waked I.

Female Sexual Dysfunction Among Egyptian Patients

with Chronic Hepatitis C. The Journal of Sexual

Medicine. 2014;11(3):768-775.


Elsaid NMAB, Mohammed HS, Ibrahim AA, Abdel-Fatah

ZF, Marie RESM and Soliman HH. The effects of

COVID-19 pandemic and its related lockdown on

female sexual function and reproductive health: An

observational study in Egypt. African Journal of

Reproductive Health. 2022;26(9):64-75.

Oueslati I, Ounissi M, Azaiez S, Talbi E, Belagha J and

Khiari K. Prevalence and risk factors of erectile

dysfunction in chronic renal failure patients. African

Journal of Urology. 2017;23(4):331-337.



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