Exposure to women’s health issues in training, practice is topic of new survey

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?

For many of us, topics in women’s health are fraught with anxiety owing to a poor knowledge base, uncertainties in the literature, or a lack of clinical experience. Yet our patients rely on us to provide the most up-to-date knowledge on these topics in order to help them make informed decisions about the life-altering events associated with kidney diseases.

Although many nephrologists have a general sense of the risks and disparities that affect women with CKD, this information is not often at the forefront of the clinical visit because women of childbearing age still represent a minority of patients seen from day to day.

Preconception counseling takes dedicated time and can elicit a variety of emotions from both the patient and provider. Reviewing a detailed obstetrical history provides insight into a woman’s risk for future proteinuria, hypertension, end stage renal disease (ESRD), and cardiovascular disease, but it is unclear if this is standard practice among nephrologists. Clinical training in women’s health is also vague and likely largely dependent on a preceptor’s personal experience. Without adequate exposure and structured didactics, discussions of safe contraception methods, fertility preservation options, optimal pregnancy timing, or appropriate anti-hypertensive and immunosuppressive agents for use while pregnant or breastfeeding may simply fall short.

CureGN is an observational prospective cohort study of biopsy-proven primary membranous nephropathy, focal segmental glomerulosclerosis, minimal change disease, and IgA nephropathy. With current enrollment including over 475 women aged 13 to 55, the study seeks to answer disease-specific questions about both pregnancy and women’s health.

The women’s health working group of CureGN is interested in your experience caring for women with CKD, and is conducting an international survey to better understand what limits your ability to provide reproductive counseling to women with CKD/ESRD, and what resources would be helpful to better serve this population.

We hope to improve the current state of clinical care for this growing population and help shape the future teaching of these clinically relevant and essential topics.

If you are an adult nephrologist, please visit https://www.surveymonkey.com/r/womens-health-nephrology to complete the survey, which is anonymous and should take less than 10 minutes to complete.

Results of the survey will allow us to compare adult nephrologists’ exposure to women’s health issues in training and current practice, their confidence in counseling and managing these issues, and ways to improve care in the future. We greatly appreciate your participation in this vital research.

March 2018 (Vol. 10, Number 3)