Living kidney donation helps address the shortage of kidneys for patients with kidney failure, or end-stage renal disease (ESRD). Despite a temporary drop due to the pandemic, living kidney donation remains the preferred option for most ESRD patients. Recipients of living donor kidneys generally have better outcomes than recipients of deceased donor kidneys.

While donors typically fare well with one kidney, there are concerns about long-term health, including sexual dysfunction. Studies on the topic show varied risks, with some reporting issues like reduced kidney function and hypertension. However, absolute risks are low.

A new study aimed to investigate sexual dysfunction in male and female living kidney donors using a healthcare database. Given the scarcity of data on this topic, the researchers anticipated no significant difference in sexual dysfunction rates in living kidney donors compared to the general population.

For the study, the researchers used the TriNetX database to study rates of sexual dysfunction in adult male and female living kidney donors over five years, comparing their outcomes to each other and with those of nonsurgical control subjects. TriNetX contains health data from over 95 million patients across 57 U.S. healthcare organizations.

To ensure accurate results, the researchers matched male and female donors based on various factors like age, race, ethnicity, and medical history. They tracked outcomes such as decreased libido, sexually transmitted diseases (STDs), and relationship problems, analyzing data from the time of kidney donation up to five years afterward. The study also included a subanalysis comparing sexual dysfunction rates between donors and nonsurgical patients of the same gender.

In the end, the researchers identified 2,385 male and 4,238 female living kidney donors from the database. Before matching, female living kidney donor patients were slightly older and had more diagnosed health conditions and medication use compared to males.

After matching, with 2,315 patients in each cohort (male and female), there were no significant differences in demographics, comorbidities, or medications between male and female living kidney donors.

The analysis found no significant difference in the 5-year incidences of decreased libido or STDs between male and female living kidney donors. Both groups had low incidences of sexual dysfunction disorders, with a slightly higher incidence in males overall. However, the differences were not statistically significant except for a composite sexual dysfunction outcome, where males had a significantly higher incidence.

Additionally, the subanalysis comparing donors with nonsurgical patients showed no significant differences in sexual dysfunction development between donor and non-donor males. Female donors had a slightly higher incidence of STD development compared to non-donors, but no significant differences in other sexual dysfunction outcomes.

In analyzing a real-world database, the researchers discovered that male living kidney donors were more likely to experience composite sexual dysfunction than female living kidney donors, although specific sexual dysfunction disorders did not differ significantly between the genders five years post-donation. Both groups showed low incidences of sexual dysfunction, but the most common issue for males was erectile dysfunction (ED). Chronic pain from surgery might contribute to this, as well as nerve damage affecting sexual function. Female living kidney donors showed few reports of sexual dysfunction.

While the study highlights the importance of discussing potential complications with living kidney donor patients, further research is needed to understand these outcomes fully, including long-term impacts and factors contributing to potential sexual dysfunction after donation.

References:

• Johnson, J. C., Venna, R., & Alzweri, L. (2024). Analysis of sexual dysfunction development among male and female living kidney donors. Sexual Medicine Reviews, 12(2), 183–191. https://doi.org/10.1093/sxmrev/qeae003