Effects of Intradialytic Exercises on Erectile Dysfunction in Men Undergoing Haemodialysis. A Pilot Randomised Controlled Trial

Abstract

BACKGROUND AND PURPOSE: Erectile dysfunctions (ED) are highly prevalent in men with chronic kidney diseases and undergoing haemodialysis (HD). The current pilot randomised controlled trial (RCT) aimed to study the effect of intradialytic aerobic exercises on ED and related outcomes in men undergoing HD. METHODS: The participants were randomly allocated to either the exercise or control group. Participants in the exercise group received intradialytic cycling exercises three times weekly for 12 weeks, and no intervention in the control group. The International Index of Erectile Function- Five Items (IIEF-5) was the primary outcome. The secondary outcomes assessed self-esteem, loneliness, depression, and stress. Independent sample t-test, Cohen d effect size, and analysis of covariance were adopted at the level of 95% confidence interval (CI). RESULTS: The IIEF-5 was improved significantly in favour of the intradialytic exercises (p < 0.01, Cohen d = 1.1). The mean difference in IIEF-5 was 2.65 points, with 95% CI ranging between 1.8 and 3.4 points. All secondary outcomes showed significant improvements in the intervention group compared with controls (p < 0.001). Haemoglobin level at the baseline was the significant covariate (t = -2.49, p = 0.019) for the change in the IIEF-5. No adverse events or side effects were observed in the exercise group. DISCUSSION: This RCT provides initial evidence supporting intradialytic aerobic exercises as an effective and safe intervention for ED and associated outcomes in HD. Early incorporation of intradialytic aerobic exercises in HD management may improve the efficacy of interventions targeting sexual outcomes such as pharmacological interventions among HD populations. Future research, including objective outcomes and biomarkers at long-term follow-up, is required to confirm the beneficial effects of the exercises.