Gender Disparity in Hemodialysis Practices and Mortality: A Nationwide Cross-Sectional Observational Study

Pub Date : 2024-07-01 DOI:10.25259/ijn_559_23
Mythri Shankar, Suresh Sankarasubaiyan, Savitha Kasiviswanathan, Kamal D Shah, Valerie Luyckx
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Abstract

Disparities between genders are well documented in incidence, progression, and outcomes of chronic kidney disease (CKD). This study aimed to describe demographic characteristics, clinical and socio-economic factors among males and females on maintenance hemodialysis and to determine any association with mortality among males and females. A nationwide cross-sectional study was conducted in a hemodialysis network in India. All adult (>18 years) patients who died while receiving maintenance hemodialysis and an equal number of surviving control patients on maintenance hemodialysis (MHD) between January 1, 2021 to March 31, 2021 were included in the study. The demographic, socioeconomic, and hemodialysis factors were compared between both the genders. A total of 1177 patients who died during the study period were included. The majority were males (824, 70.01%). Males were more educated than females (P < 0.001). The proportion of female patients dialysed with temporary catheters where more than males, who had definite vascular access such as AV fistula or AV graft (P < 0.001). More female patients required out-of-pocket expenditure (P = 0.005). Multivariate logistic regression demonstrated that lower educational status, hypoalbuminemia, previous history of hospitalization, and dialysis in centres run by Public Private Partnership (PPP) were associated with mortality in males. Lower educational status, heart failure and previous history of hospitalization were the factors associated with mortality in females. Males predominated on hemodialysis. Females were less educated and were less likely to be covered under public or private health insurance compared to males.
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血液透析操作和死亡率中的性别差异:一项全国性横断面观察研究
在慢性肾脏病(CKD)的发病率、进展和预后方面,两性之间的差异有据可查。本研究旨在描述接受维持性血液透析的男性和女性的人口统计学特征、临床和社会经济因素,并确定男性和女性死亡率之间的关联。研究纳入了 2021 年 1 月 1 日至 2021 年 3 月 31 日期间在接受维持性血液透析期间死亡的所有成年(大于 18 岁)患者,以及同等数量的维持性血液透析(MHD)存活对照患者。共纳入了 1177 名在研究期间死亡的患者。其中男性占大多数(824 人,70.01%)。男性受教育程度高于女性(P < 0.001)。使用临时导管透析的女性患者比例高于使用明确血管通路(如动静脉瘘或动静脉移植)的男性患者(P < 0.001)。需要自费的女性患者更多(P = 0.005)。多变量逻辑回归显示,教育程度较低、低白蛋白血症、既往住院史以及在公私合营(PPP)中心进行透析与男性患者的死亡率有关。教育程度较低、心力衰竭和既往住院史是女性死亡率的相关因素。与男性相比,女性受教育程度较低,且较少参加公共或私人医疗保险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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