Sodium glucose co-transporter 2 inhibitors (SGLT2Is) effect on erectile dysfunction (ED) in patients with chronic kidney disease (CKD).

Background: ED is commonly encountered among male CKD patients. SGLT2Is were recently recommended as a universal treatment for CKD. It's hypothesized that the mechanism of action of SGLT2Is could be related to improving endothelial dysfunction. So, patients with ED due to CKD might benefit from adding SGLT2Is to their management. We aimed to study the effect of SGLT2Is on ED in CKD patients.

Methods: After complete clinical examination and laboratory investigations needed to exclude other causes of ED, 34 CKD cases were randomly assigned to receive either empagliflozin (Empa) or dapagliflozin (Dapa). All selected candidates signed a written consent and were then referred to the Andrology clinic for assessment for ED. The structured questionnaire (International Index of Erectile Function) was used before starting and 3 months after use of the assigned SGLT2I.

Results: Both SGLT2Is were associated with highly significant improvement in kidney function as well as IIEF-5 (P < 0.001 in all).

Conclusion: SGLT2Is improve endothelial function and correct pericyte depletion induced by uremia. The postulated mechanisms of action that improve erectile function are discussed.