Researchers examined five decades of data on the prevalence of
chronic kidney disease and receipt of kidney replacement therapies
like dialysis and transplants in nine European countries. Throughout
the study period, women consistently lagged behind men in receipt of
kidney replacement therapies - with about 60% of men and 40% of
women who needed the treatments receiving them.
"These findings neither prove nor disprove the existence of gender
disparity, but these results nevertheless might sensitize patients
and their caretakers to potential sex differences, especially when
it comes to initiating kidney replacement therapy," said Dr. Manfred
Hecking, senior author of the study and associate professor of
internal medicine at the Medical University of Vienna.
That's because the best time to consider dialysis or a transplant
may vary from one patient to the next, and it's unclear from the
study results how much the disparities might have been influenced by
biology, access to care, or other factors, Hecking and colleagues
write in the Clinical Journal of the American Society of Nephrology.
"The best timing of kidney replacement therapy initiation is matter
of debate," Hecking said by email.
Clear reasons for kidney replacement therapy include severe fluid
overload that can lead to congestion in the lungs as well as high
potassium levels that can cause heart rhythm abnormalities, Hecking
said.
"Kidney replacement therapy helps normalize these problems, and
people who need kidney replacement therapy but don't receive it
might die."
It's not clear if women might have slower progression of kidney
disease than men, making it possible for them to go longer before
needing kidney replacement therapy, Hecking said.
But without needed dialysis, it's also possible that women have a
higher risk of dying from kidney problems than men because women
tend to live longer and have lower risk of dying from something
else, Hecking added.
[to top of second column] |
To examine sex differences in kidney replacement therapy over time,
Hecking and colleagues analyzed data reported to the European Renal
Association-European Dialysis and Transplant Association Registry
from 1965 to 2015.
The study included information on 230,378 patients, and 39% were
women.
The gender gap in receipt of kidney replacement therapy widened with
age.
However, the gap remained consistent over time even as the main
reasons for dialysis and transplants shifted to include more people
with kidney failure resulting from diabetes.
The study wasn't designed to prove whether or how sex might impact
receipt of kidney transplants or dialysis.
Still, the results suggest that patients should educate themselves
about their treatment options when they have chronic kidney disease,
said Dr. Catherine Clase of St. Joseph's Hamilton Healthcare and
McMaster University in Ontario, Canada.
"Women with low kidney function should receive education on their
options and, supported by their social structures and their health
care team, should feel free to make the decision for themselves
about which management options they prefer," said Clase, co-author
of an editorial accompanying the study.
"In this regard, many people, both women and men, would prefer
transplantation, but a big problem here is the relative scarcity of
live donors," Clase said by email.
"People with good kidney function, who are close to someone with
kidney failure who is eligible for a kidney transplant, should
strongly consider being assessed as potential donors," Clase added.
"All people should advocate for health policy that reimburses costs
to donors and prioritizes a former donor who now has kidney failure
to receive a transplant themselves."
SOURCE: https://bit.ly/2qexKAo and https://bit.ly/2po1dYU Clinical
Journal of the American Society of Nephrology, online October 24,
2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |