A New Approach for Measuring Gender Disparity in Access to Renal Transplantation Waiting Lists

Couchoud, Cécile; Bayat, Sahar; Villar, Emmanuel; Jacquelinet, Christian; Écochard, René

doi:10.1097/tp.0b013e31825d156a

Cited by 86 publications

(75 citation statements)

References 32 publications

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“…This finding is consistent with results of previous reports from the US and Scotland (26,30). It also confirms results previously reported for France with a different methodological approach (24).…”

Section: Discussionsupporting

confidence: 83%

“…It might thus be difficult to perceive at a clinical level. Nonetheless, because women have fewer comorbidities, they logically should be more likely to reach the waiting list (24).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, a wide variety of patient-level factors have been associated with access to renal transplant waiting lists, including not only medical factors (diabetes, cardiovascular disease and other comorbidities, and causes of ESRD), but also nonmedical factors such as gender and race/ethnicity (23)(24)(25)(26)(27)(28)(29)(30)(31). Studies have also shown center-level factors (private ownership of dialysis facilities, size of renal unit, and listing practice for living donor transplantation) to be related to access to waiting lists (25,32).…”

Section: Introductionmentioning

confidence: 99%

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Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

Bayat

Macher

Couchoud

et al. 2015

American Journal of Transplantation

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Several studies have investigated geographical variations in access to renal transplant waiting lists, but none has assessed the impact on these variations of factors at both the patient and geographic levels. The objective of our study was to identify medical and nonmedical factors at both these levels associated with these geographical variations in waiting-list placement in France. We included all incident patients aged 18-80 years in 11 French regions who started dialysis between January 1, 2006, and December 31, 2008. Both a multilevel Cox model with shared frailty and a competing risks model were used for the analyses. At the patient level, old age, comorbidities, diabetic nephropathy, non-autonomous first dialysis, and female gender were the major determinants of a lower probability of being waitlisted. At the regional level, the only factor associated with this probability was an increase in the number of patients on the waiting list from 2005 to 2009. This finding supports a slight but significant impact of a regional organ shortage on waitlisting practices. Our findings demonstrate that patients' age has a major impact on waitlisting practices, even for patients with no comorbidity or disability, whose survival would likely be improved by transplantation compared with dialysis.

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Section: Discussionsupporting

confidence: 83%

“…It might thus be difficult to perceive at a clinical level. Nonetheless, because women have fewer comorbidities, they logically should be more likely to reach the waiting list (24).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

Bayat

Macher

Couchoud

et al. 2015

American Journal of Transplantation

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“…Данные из различ-ных стран, в том числе из США, Франции, Китая и Индии, подтверждают различия в частоте транс-плантации почек (у женщин ниже, чем у мужчин), а также меньшую вероятность попасть в лист ожи-дания и большую длительность пребывания на ди-ализе до включения в лист ожидания для женщин. Матери и жены с большей вероятностью окажутся донорами почки [91,[105][106][107][108]. Гендерное неравен-ство существует и в педиатрической популяции.…”

Section: гендерные различия в доступе к трансплантации почкиunclassified

What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman’s Day

et al. 2018

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“…22 Women have lower probability of referral to waiting list for kidney transplantation and longer delay between dialysis and waiting list compared to men. [23][24][25] Women had significantly lower liver transplantation rates than men from 1997 to 2007 and greater deficit to men since. 26 Women had pain years longer than men before referral to pain clinic, where women are prescribed minor tranquilizers, sedatives, or antidepressants vs analgesics and opioids for men.…”

mentioning

confidence: 99%

Because Women’s Lives Matter, We Need to Eliminate Gender Bias

2017

Critical Care Nurse

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Using written vignettes of homicides that differed only in sex of perpetrator, forensic psychiatrists and students diagnosed the defendant as legally insane significantly more often when perpetrator was a woman. 11World Health Organization 12 and US 13 research found most behavioral disorders (depression, anxiety) are diagnosed twice as often in women.Men receive more intensive treatments than women for common conditions. 14 85% of men vs 55% of women receive oral antihyperglycemics. 15 Despite the UK NICE guideline 27 13,16 (mandates "urgent referral to an oncologist" for painless macroscopic hematuria), 27% of women vs 10% of men had multiple consults before referral. Bladder cancer 5-year survival rate is 57% for men, 44% for women. 17,18 Female gender is independent risk factor for delayed referral and diagnosis of bladder and renal cancer. 19 TKA referral in patients with comparable osteoarthritis severity: physicians deny sex influences referral, but referral rate for men is 3 times that for women. Using identical standardized patients, 42% of physicians recommended TKA for the male, but not the female. Odds of primary care physicians recommending TKA for men was twice that for women; for orthopedic physicians, odds for men was 22 times that for women. 20Patients with osteoarthritis needing hip replacement, women less likely than men to receive 4 of 5 care stages: consult with general practitioner, specialist referral, orthopedic consult, wait listed. 21 Women have more disability before referral. 22Women have lower probability of referral to waiting list for kidney transplantation and longer delay between dialysis and waiting list compared to men. 23-25Women had significantly lower liver transplantation rates than men from 1997 to 2007 and greater deficit to men since. 26Women had pain years longer than men before referral to pain clinic, where women are prescribed minor tranquilizers, sedatives, or antidepressants vs analgesics and opioids for men. 27After abdominal surgery, physicians prescribed less pain medication for women compared to men; nurses gave less pain medication to women. 28After CABG, men received narcotics, women given sedatives. 29First report on gender attributes of pain: physicians minimized women's pain by attributing it to emotional causes. 30 80 physicians (44 men) and 113 nurses (103 women) more likely to treat male patients with opioids than females. Disparity greater for nurses than physicians. 31Despite ACC/AHA PAD guidelines, at discharge, women are significantly less likely than men to be prescribed 3 recommended therapies: statins, aspirin, and β-blockers. 32,33Women are offered surgical revascularization less often (36.4%) than men (53.8%) and are offered CEA less often at all ages. 34 When CEA is offered to women, it is often on a very delayed basis. Delays persist after adjusting for age, history, preoperative TIA, ABCD2 score, degree of stenosis, unilateral symptoms, and symptomatic stenosis. 34 Findings most concerning because female gender is a known, negative, independ...

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A New Approach for Measuring Gender Disparity in Access to Renal Transplantation Waiting Lists

Abstract: These poorly understood gender-based inequities require further consideration.

Cited by 86 publications

References 32 publications

Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman’s Day

Because Women’s Lives Matter, We Need to Eliminate Gender Bias

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