Women and Kidney Diseases

Women and Kidney Diseases

This year’s World Kidney Day falls on International Women’s Day, offering the nephrology community an excellent time to reflect on the theme, “Kidneys & Women’s Health: Include, Value, Empower.”

What progress have we made in addressing women’s kidney health? Why do so many unanswered questions remain? Most important, how do we as nephrologists currently care for women with chronic kidney disease (CKD)? How do we empower them?

Enigmas abound in the clinical care and research related to acute kidney injury (AKI). Unfortunately, little conversion of research findings to changes in patient care has occurred.

Investigators who are designing clinical trials and preclinical studies have realized that results found in males do not always hold true in females, and that there are clear differences in the sexes that should be considered when preventing and treating a wide variety of health issues. Kidney researchers also note that because female physiology is optimized for successful reproduction—which entails large fluctuations in vascular, hemodynamic, and renal function—it’s likely that female kidneys have important differences from those of males.

Studies have shown gender disparities in care for many chronic diseases, and ESRD is no exception.

Studies from the early 2000s suggested that women had lower rates of hemodialysis initiation using an arteriovenous fistula (AVF), the preferred hemodialysis vascular access. A recent study in Hemodialysis International analyzed gender-related differences in AVF use at dialysis initiation, including variations between ESRD regional networks.

The risk of developing CKD is at least as high in women as in men, and possibly higher. Yet the number of women receiving dialysis is lower than the number of men, and women are more likely to donate kidneys but less likely to receive transplants.

The March 2018 World Kidney Day theme, “Kidneys & Women’s Health: Include, Value, Empower,” aims to shine a light on issues of equitable healthcare access for women with kidney diseases worldwide.