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Patients who are on dialysis have multiple reasons why you can't get an erection. It could be due to the underlying reason why your kidneys failed in the first place. However, accumulation of ammonia in the blood can also prevent you from getting erections. You need to get into see a urologist for an examination to determine what your underlying cause is. You likely will need to be started first on an oral medication such as Viagra or Cialis to see if this improves the blood flow. If this does not, then the next option is to consider self injections of the medication such as Trimix into the penis to improve the blood flow each time you want to have an erection. Hope this helps and let me know if you have