{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T07:10:10Z","timestamp":1751267410851,"version":"3.41.0"},"reference-count":19,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Erectile dysfunction (ED) is one of the complications in male patients with end-stage chronic kidney disease (CKD). Renal replacement therapy may improve general conditions and thus improve erectile function. This study aims to determine changes in erectile dysfunction in end-stage CKD patients who underwent hemodialysis, focusing on changes in laboratory parameters. This cross-sectional study was conducted from March to April 2024 at the Hemodialysis Unit of Wangaya General Hospital. The subjects were male patients with end-stage chronic kidney disease (CKD) who were undergoing hemodialysis and met the specific inclusion and exclusion criteria. Erectile function was assessed using the International Index of Erectile Function (IIEF- 5) and the Erection Hardness Score (EHS). Laboratory parameters, including hemoglobin, hematocrit, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were recorded. Twenty-two subjects were included in this study. The prevalence of ED before starting hemodialysis and after a period of at least 3 months of hemodialysis was 28.3% and 86.4% respectively. A statistically significant difference was observed in the IIEF-5 scores of patients before and after hemodialysis (p=0.001). Significant differences were observed in the erection degree before and after hemodialysis based on IIEF-5 (p=0.001) and EHS (p=0.001). There was a significant correlation between erection degree assessed by IIEF-5 and hemoglobin, hematocrit, NLR and PLR; and erection degree assessed by EHS and hemoglobin, hematocrit, and PLR, (all p&lt;0.05). In conclusion, there is a deterioration in erectile function in patients undergoing hemodialysis compared to their condition before hemodialysis. There was a significant correlation between hemoglobin, hematocrit, NLR, and PLR and erectile dysfunction.<\/jats:p>","DOI":"10.4081\/aiua.2025.13856","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T06:42:31Z","timestamp":1751265751000},"source":"Crossref","is-referenced-by-count":0,"title":["Exploring the association between hemoglobin, hematocrit, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with erectile dysfunction in chronic kidney disease patients undergoing hemodialysis: a cross-sectional study"],"prefix":"10.4081","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6388-7581","authenticated-orcid":false,"given":"Anak Agung Ngurah Krisnanta","family":"Adnyana","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I Wayan","family":"Suarsana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anak Agung Patriana","family":"Puspaningrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4873-2951","authenticated-orcid":false,"given":"Ida Bagus Oka Widya","family":"Putra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"184304","doi-asserted-by":"crossref","unstructured":"Warli SM, Alamsyah MT, Nasution AT, et al. The assessment of male erectile dysfunction characteristics in patients undergoing continuous ambulatory peritoneal dialysis and hemodialysis using the international index of erectile function (IIEF-5) combined with hospital anxiety and depression scales. Int J Nephrol Renovasc Dis. 2023; 16:155-61.","DOI":"10.2147\/IJNRD.S402540"},{"key":"184305","doi-asserted-by":"crossref","unstructured":"Muneer A, Kalsi J, Nazareth I, Arya M. Erectile dysfunction. BMJ. 2014;27;348.","DOI":"10.1136\/bmj.g129"},{"key":"184306","doi-asserted-by":"crossref","unstructured":"NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993; 270:83-90.","DOI":"10.1001\/jama.1993.03510010089036"},{"key":"184307","doi-asserted-by":"crossref","unstructured":"Chen L, Shi GR, Huang DD, et al. Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention. 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Electron Physician. 2016; 8:2371-7.","DOI":"10.19082\/2371"},{"key":"184312","doi-asserted-by":"crossref","unstructured":"Duarsa GWK, Kandarini Y, Winarta GK, et al. A comparison of erectile dysfunction improvement between patients with regular hemodialysis and patients with continuous ambulatory peritoneal dialysis. J Sex Med. 2021; 18:920-5.","DOI":"10.1016\/j.jsxm.2021.02.007"},{"key":"184313","doi-asserted-by":"crossref","unstructured":"El-Assmy A. Erectile dysfunction in hemodialysis: A systematic review. World J Nephrol. 2012; 1:160-5.","DOI":"10.5527\/wjn.v1.i6.160"},{"key":"184314","doi-asserted-by":"crossref","unstructured":"Fernandes GV, Dos Santos RR, Soares W, et al. The impact of erectile dysfunction on the quality of life of men undergoing hemodialysis and its association with depression. J Sex Med. 2010; 7:4003-10.","DOI":"10.1111\/j.1743-6109.2010.01993.x"},{"key":"184315","doi-asserted-by":"crossref","unstructured":"Ali MEM, Abdel-Hafez HZ, Mahran AM, et al. Erectile dysfunction in chronic renal failure patients undergoing hemodialysis in Egypt. Int J Impot Res. 2005; 17:180-5.","DOI":"10.1038\/sj.ijir.3901286"},{"key":"184316","unstructured":"Tsai WK, Chiang PK, Chen M, Yang S. Prevalence and correlates of erectile dysfunction among end-stage renal disorder patients on hemodialysis. Hypertension. 2008; 52:49-1."},{"key":"184317","doi-asserted-by":"crossref","unstructured":"Neto AF, de Freitas Rodrigues MA, Saraiva Fittipaldi JA, Moreira ED Jr. The epidemiology of erectile dysfunction and its correlates in men with chronic renal failure on hemodialysis in Londrina, southern Brazil. Int J Impot Res. 2002; 14:19-26.","DOI":"10.1038\/sj.ijir.3900894"},{"key":"184318","doi-asserted-by":"crossref","unstructured":"Cerqueira J, Moraes M, Glina S. Erectile dysfunction: prevalence and associated variables in patients with chronic renal failure. Int J Impot Res. 2002; 14:65-71.","DOI":"10.1038\/sj.ijir.3900811"},{"key":"184319","doi-asserted-by":"crossref","unstructured":"Messina LE, Claro JA, Nardozza A, et al. Erectile dysfunction in patients with chronic renal failure. Int Braz J Urol. 2007; 33:673-8.","DOI":"10.1590\/S1677-55382007000500008"},{"key":"184320","doi-asserted-by":"crossref","unstructured":"Sambel M, Kilic M, Demirbas M, et al. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J Impot Res. 2018; 30:27-35.","DOI":"10.1038\/s41443-017-0007-1"},{"key":"184321","unstructured":"Aslan A, Kaya Y, \u00c7\u0131rakoglu A, et al. Neutrophil-lymphocyte ratio could be a marker for erectile dysfunction. Urol J. 2019; 16:216-20."},{"key":"184322","doi-asserted-by":"crossref","unstructured":"Pakpahan C, Ilhamsyah I, Supardi S, et al. The interplay between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, erectile dysfunction, and Peyronie\u2019s disease: A meta-analysis of observational studies. 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