If you happen to be among those individuals who have kidney problems but have been experiencing difficulties with manhood, then rest assured you are not in this boat by yourself. So, can kidney disease cause erectile dysfunction? Kidney disease is associated with ED and ED is common in men with chronic kidney disease, although estimates vary widely between studies. Possible contributors include poor circulation, low testosterone, nerve damage and some medicines.
The good news is that a doctor can discuss options with you. Here is why it may happen and what you can do about it.
How Common Is ED in Men Suffering From Kidney Disease?
ED is common in men with chronic kidney disease (CKD). A meta analysis of 34 studies with 5,986 men reported a pooled prevalence of 76%, but results varied widely between studies. Healthy Male reports that about one in five Australian men over 40 has ED. The CDC also notes that many people with CKD have sexual health problems.
Reported prevalence differs between patient groups. A 2021 meta analysis of 94 studies including 10,320 men with end stage kidney disease reported an overall pooled prevalence of 71% (95% CI 67% to 74%) with high variation between studies.
Group | Pooled ED prevalence | 95% confidence interval |
Men starting dialysis | 82% | 75% to 88% |
Men on haemodialysis | 79% | 75% to 82% |
Men on peritoneal dialysis | 71% | 58% to 83% |
Kidney transplant recipients | 59% | 53% to 64% |
These figures come from different studies and different groups of men. They should not be read as a progression over time.
A separate 2025 meta-analysis of 28 studies reported a pooled prevalence of 53% (95% CI 48% to 58%) in kidney transplant recipients compared with 59% in the review above. Older age and diabetes were associated with ED.
In Australia, about 2.7 million adults (14.2%) had biomedical signs of CKD in 2022 to 2024, according to the AIHW. In the same survey, only 7.4% of those adults reported having CKD, so some men may have kidney disease and ED without knowing about the kidney disease.
Why Kidney Disease Causes Erectile Dysfunction
In the majority of instances, multiple causes are seen. As per the National Kidney Federation (UK), men with kidney problems have problems with their sexual life due to a mix of reasons.
Cause | How it affects erections | Source |
Narrowed blood vessels | Kidney failure is usually associated with diabetes, hypertension, and high cholesterol levels affecting arteries and blood vessels including blood vessels that supply blood to the penis. Deposits of calcium can contribute to the narrowing process. | |
Leaky veins | An erection is lost when blood from the penis exits through the leaking veins. | |
Chronic kidney disease disrupts the signaling of hormones from the brain to the testes. The CDC says that CKD affects the production of the luteinizing hormone that stimulates the release of testosterone. | ||
Nerve damage | Chronic kidney disease can be responsible for dysfunction of the penile nerve supply. | |
Anaemia and tiredness | Fatigue may be due to anaemia, lack of dialysis or cardiac problems therefore could lead to sex problems | |
Poor sleep | Men need to sleep for three to five hours to experience the morning surge of testosterone. Non-continuous urination at night can break sleep. | |
Depression and anxiety | Being ill may lead to a lack of interest in sex |
The signs indicating a problem may be hard to recognize. The first problem which might be noticed is fewer erections at night.
Mike Kirby, the specialist for men's health comments: “diabetes is one of the important grounds for developing CKD and there is exact research showing that men with diabetes had 2.66 odds of meeting the issue of ED."
Can Kidney Disease Medicines Affect Erections?
Some medicines may contribute to erection problems, but the condition they treat can also play a role. Ask your doctor to review your medicines before making any changes.
Medicine type | Examples | What the sources say |
Beta-blockers | Atenolol, propranolol, metoprolol, bisoprolol | Listed by the National Kidney Federation as a possible contributor, but the evidence is mixed |
Diuretics (water tablets) | Furosemide, hydrochlorothiazide | The CDC says some blood pressure medicines, including diuretics, may affect sexual health. A Kidney Care UK specialist lists them as a possible contributor |
Calcium channel blockers | Amlodipine | Listed as a possible contributor by the same specialist, but a 2025 review found them neutral for erectile function |
ACE inhibitors and ARBs | Ramipril, candesartan | The same 2025 review found neutral or even positive effects on erections |
Antidepressants | Various | The CDC notes they may affect sexual health |
Kidney function and dialysis can also play a role. The National Kidney Federation notes that fatigue linked to anaemia or inadequate dialysis may contribute to sexual problems. Your kidney team may review these as part of your care
One should never stop their kidney or blood pressure medicine on their own. One needs to consult a doctor about other options available in order to avoid possible complications.
Who Is At Higher Risk & When to See a Doctor
Kidney disease raises your risk and other factors stack on top of it.
Risk factor | What the research found | Source |
Starting dialysis | Pooled prevalence of 82% in men starting dialysis | |
2.66 times the odds of moderate or complete ED in Australian men | ||
Anxiety or depression treatment | 2.36 times the odds | |
1.86 times the odds | ||
Age | Odds of ED rise 11% with each year of age after 45 | |
Older age and diabetes after transplant | Both predicted ED in kidney transplant recipients |
ED can be an early warning sign.
Healthy Male states that ED can serve as the first sign of cardiovascular health problems, whose risk factors are similar to those in the case of heart disease and kidney disease. If you suffer from ED together with other problem factors, like diabetes, hypertension or smoking, consider asking your doctor for a Kidney Health Check. Kidney Health Australia suggests having one Kidney Health Check every 1-2 years depending on your factors. The check consists of measuring blood pressure, analyzing urine and blood.
When to see a doctor
You should visit a doctor if:
- You have ED lasting for several weeks or occurring time after time
- You experience kidney disease and have fewer erections at night or reduced sex drive
- Your ED began after using a new medication or a change in the dialysis process
- Your ED comes with such symptoms as swollen ankles, excess tiredness and changes in your urination which may indicate kidney problems
Do not anticipate your kidney staff to bring this up. According to an expert in men’s health from Kidney Care UK, 80% of individuals would like health professionals to discuss this topic with them, but many doctors and nurses may feel shy and do not have the proper knowledge to do so.
Management and Treatment: What Works
ED in men with kidney disease is often treatable and your treating team can advise on the options. Your treating team can look at your overall health alongside ED treatment.
- Review the underlying causes. Your kidney team may look at anaemia, dialysis and your medicines. Do not change any of these yourself.
- Ask whether hormone testing is appropriate. A doctor may check testosterone and related hormones. Testosterone treatment is only considered where low testosterone has been confirmed.
- Pay attention to mental health and relationships. Be it anxiety or depression, talking treatment always helps.
- Take care of the most basic health parameters. The most important parameters would be blood pressure, sugar level, and cholesterol as they destroy the vessels supplying blood to the penis.
- Don’t forget to collect information about specific treatments for ED; this will be done below.
ED Treatment Options For Men With Kidney Disease
Option | How it works | Kidney-specific notes |
Prescription ED tablets | Support blood flow to the penis | Whether a tablet is suitable depends on your kidney function, dialysis or transplant status and other medicines. Some are not suitable in some of these situations. They must not be combined with nitrate medicines (used for chest pain). Ask your GP, kidney specialist or transplant team for a medication review before starting anything. |
Testosterone treatment | Replaces testosterone | Only an option after a doctor has assessed you and confirmed low testosterone. Your treating team will advise whether it is appropriate. |
A drug free device that draws blood into the penis | Results vary between men. Ask your treating team whether it suits you. | |
Prescription penile injection | Medicine injected into the penis | Ask your treating team about timing around dialysis and about bleeding risk, especially if you use heparin or another anticoagulant. |
Surgical option | Usually considered when other treatments have not worked or are not suitable. A specialist can discuss the risks and benefits. |
In Australia, prescription ED medicines need a doctor’s assessment first. Kidney function and other medicines affect which treatment is suitable so ask your GP, kidney specialist or transplant team for a medication review
Talk to an Australian doctor online
DirectMeds offers online consultations with AHPRA registered doctors, subject to availability. Tell the doctor about your kidney disease, dialysis or transplant and all your medicines. They may recommend that you also speak with your kidney specialist or transplant team. Start your online ED assessment with DirectMeds.
Frequently Asked Questions
Can Kidney disease cause ED?
Kidney disease is associated with ED, and ED is common in men with CKD. A meta analysis of 5,986 men reported a pooled prevalence of 76%, but results varied widely between studies. Possible contributors include narrowed blood vessels, low testosterone, nerve damage, anaemia and low mood.
Does dialysis cause ED?
ED is common in men on dialysis. A meta analysis reported a pooled prevalence of about 79% in men on haemodialysis and 71% in men on peritoneal dialysis. These figures show how common ED is in these groups, not whether dialysis itself causes it because kidney disease, other health conditions and medicines also play a role.
Will a kidney transplant fix ED?
Not necessarily. Reviews report ED in about 53% to 59% of kidney transplant recipients, so ED is still common after a transplant. These are different groups of men so the figures do not show how a transplant changes ED for any one person. The American Kidney Fund notes that some men have fewer ED problems after a transplant but outcomes vary. Talk to your transplant team.
Can kidney medicines cause ED?
Some medicines may contribute to erection problems, but the condition they treat can also play a role. The CDC notes that some blood pressure medicines, such as diuretics, and antidepressants may affect sexual health. Ask your doctor to review your medicines before making any changes. Never stop a medicine on your own.
Are ED medicines safe to use if you have kidney disease?
It depends. Whether an ED medicine is suitable depends on your kidney function, whether you are on dialysis or have had a transplant and your other medicines. Some are not recommended in some of these situations and they must not be combined with nitrate medicines. Ask your GP, kidney specialist or transplant team for a medication review before starting any treatment.
Does ED mean I have kidney disease?
No. ED can be the result of a lot of causes and around one-fifth of Australian males above 40 years experience it. However, if you have diabetes, high blood pressure or other risk factors, it is a good idea to ask your doctor about a kidney check, because many people with signs of CKD don’t know they have it (AIHW).