Comorbidity Burden in Hemodialysis Population Greater in Women

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Higher percentages of women than men on hemodialysis have anemia, infections, hypertension, and diabetes, study finds.
Higher percentages of women than men on hemodialysis have anemia, infections, hypertension, and diabetes, study finds.
The following article is part of conference coverage from Kidney Week 2018 in San Diego 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 2018.

SAN DIEGO—Among hemodialysis (HD) patients, women are disproportionally affected by certain common, non-renal comorbidities, according to study findings presented at the American Society of Nephrology's Kidney Week 2018 conference.

Sophia Rosen, PhD, and collaborators from Fresenius Medical Care North America (FMCNA) in Waltham, Massachusetts, analyzed data from 230,091 HD patients (43% female). Anemia affected a greater proportion of women than men in the age groups 50 to 54 years and older than 65 years. Women contracted more infections than men, and at younger ages (25 to 29 and over 75 years). Hypertension also differentially affected the sexes: More women aged 30 to 35 year and older than 65 years developed high blood pressure compared with similarly aged men. Women also had more diabetes. In many age groups, a disproportionate number of women had secondary hyperparathyroidism.

Cardiovascular disease affected the sexes similarly, except for a slightly higher incidence in men aged 75 to 85 years. The investigators observed no sex or age differences in gastrointestinal bleeding.

Comorbidities are associated with decreased quality of life and poorer outcomes, according to the investigators. How these sex differences might affect dialysis outcomes needs further study.

“Women and men have physiological, hormonal, and genetic differences that affect their health. It is not so surprising that some comorbidities might be more prevalent in women than in men and vice versa,” co-author Marta Reviriego-Mendoza, PhD, told Renal & Urology News. Social, economic, and geographic factors also may play a role, she added.

As co-author Dugan Maddux, MD, Vice President of Kidney Disease Initiatives at FMCNA explained: “Younger women appear to have an increased risk of infection compared to older women which may be physiologic and/or psychosocial. Issues related to vascular access or childcare may interfere with their clinical care.”

“With more insights from research, we can design interventions specific to a patient's sex, age, and socioenvironmental conditions to improve health,” Dr Reviriego-Mendoza said.

The study was sponsored by Fresenius Medical Care North America.


Visit Renal & Urology News' conference section for continuous coverage from Kidney Week 2018.


Reference

Rosen S, Maddux D, Larkin JW, Usvyat LA, Maddux F, Reviriego-Mendoza M. Sex- and age-associated differences in the prevalence of comorbidities in dialysis patients. Presented at the American Society of Nephrology's Kidney Week 2018 conference in San Diego, Oct. 23-28. Poster TH-PO291.

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