|The following article is part of conference coverage from Kidney Week 2017 in New Orleans hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2017.|
NEW ORLEANS—Survival in pediatric end-stage renal disease (ESRD) patients differs by gender, according to a new study presented at the American Society of Nephrology’s Kidney Week 2017 meeting.
“Mortality risk is substantially higher for girls with ESRD than for boys,” said Patrick Ahearn, MD, of the University of California, San Francisco, who presented study findings. “This difference in the risk of death is not entirely explained by lower access to transplant among girls.”
Dr Ahearn and colleagues examined mortality in 13,087 children aged 2–19 years in the US Renal Data System who started renal replacement therapy during 1995 to 2011. Over 7.4 years of follow-up, 1694 patients died. Using a Cox proportion hazards model, the investigators found a 35% higher risk of death for girls, especially those aged 13 and older, after adjustment for potential confounders such as body mass index, cause of ESRD, and household income. Dialysis modality was not a factor. Girls had a higher death risk s whether they were on dialysis or had a kidney transplant.
Transplant access is an area of discrepancy. Girls were 7% less likely to receive a kidney transplant than boys. This risk lessened somewhat when the team further adjusted for transplant as a time-dependent variable.
“Efforts to increase preemptive transplantation rates, which are lower among girls, might improve parity in transplantation access,” Dr Ahearn told Renal & Urology News.
Dr Ahearn and his colleagues are planning studies to identify other possible disparities in access to kidney transplantation, such as inadequate donor and recipient work-up or unfavorable recipient clinical characteristics. “We hope our work also encourages further studies by others to identify barriers to transplantation among girls,” Dr Ahearn added.
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1. Ahearn P, Johansen KL, McCulloch CE, Grimes BA, and Ku E. Higher risk of mortality among girls with ESRD Is mediated by lower access to transplant. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 – Nov. 5). Abstract TH-PO947.