Kidneys and women's health: key challenges and considerations

Ashuntantang, Gloria; Garovic, Vesna D.; Heilberg, Ita Pfeferman; Lightstone, Liz

doi:10.1038/nrneph.2017.188

Cited by 15 publications

(16 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, kidney disease has evolved from a subspeciality concern to a global health problem [1,2]. More recently, the scientific community has become increasingly aware of sex-specific influences on the incidence and progression of renal disorders [3]. Worldwide, it has been reported that the proportion of women with earlier stages of CKD is higher than that of men.…”

Section: Introductionmentioning

confidence: 99%

Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study

et al. 2019

View full text Add to dashboard Cite

Background Preeclampsia has been suggested to increase the risk of end-stage kidney disease (ESKD); however, most studies were unable to adjust for potential confounders including pre-existing comorbidities such as renal disease and cardiovascular disease (CVD). We aimed to examine the association between preeclampsia and the risk of ESKD in healthy women, while taking into account pre-existing comorbidity and potential confounders. Methods and findings Using data from the Swedish Medical Birth Register (MBR), women who had singleton live births in Sweden between 1982 and 2012, including those who had preeclampsia, were identified. Women with a diagnosis of chronic kidney disease (CKD), CVD, hypertension, or diabetes prior to the first pregnancy were excluded. The outcome was a diagnosis of ESKD, identified from the Swedish Renal Registry (SRR) from January 1, 1991, onwards along with the specified cause of renal disease. We conducted Cox proportional hazards regression analysis to examine the association between preeclampsia and ESKD adjusting for several potential confounders: maternal age, body mass index (BMI), education, native country, and smoking. This analysis accounts for differential follow-up among women because women had different lengths of follow-up time. We performed subgroup analyses according to preterm preeclampsia, small for gestational age (SGA), and women who had 2 pregnancies with preeclampsia in both. The cohort consisted of 1,366,441 healthy women who had 2,665,320 singleton live births in Sweden between 1982 and 2012. At the first pregnancy, women’s mean (SD) age and BMI were 27.8 (5.13) and 23.4 (4.03), respectively, 15.2% were smokers, and 80.7% were native Swedish. The overall median (interquartile range [IQR]) follow-up was 7.4 years (3.2–17.4) and 16.4 years (10.3–22.0) among women with ESKD diagnosis. During the study period, 67,273 (4.9%) women having 74,648 (2.8% of all pregnancies) singleton live births had preeclampsia, and 410 women developed ESKD with an incidence rate of 1.85 per 100,000 person-years. There was an association between preeclampsia and ESKD in the unadjusted analysis (hazard ratio [HR] = 4.99, 95% confidence interval [CI] 3.93–6.33; p < 0.001), which remained in the extensively adjusted (HR = 4.96, 95% CI 3.89–6.32, p < 0.001) models. Women who had preterm preeclampsia (adjusted HR = 9.19; 95% CI 5.16–15.61, p < 0.001) and women who had preeclampsia in 2 pregnancies (adjusted HR = 7.13, 95% CI 3.12–16.31, p < 0.001) had the highest risk of ESKD compared with women with no preeclampsia. Considering this was an observational cohort study, and although we accounted for several potential confounders, residual confounding cannot be ruled out. Conclusions The present findings suggest that women with preeclampsia and no major comorbidities before their first pregnancy are at a 5-fold in...

show abstract

Section: Introductionmentioning

confidence: 99%

Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…It is also possible that imprecise estimation of renal function in women and gender bias in the approach to ESKD care (including approach to and barriers precluding timely access to transplant wait‐listing and subsequent transplantation) are operative . Identifying potential modifiable factors is urgently needed to better understand and reduce this sex disparity in the management of women with ESKD …”

Section: Sex Disparitymentioning

confidence: 99%

Impending challenges of the burden of end‐stage kidney disease in Australia

Lim¹,

Johnson

McDonald

et al. 2019

Medical Journal of Australia

View full text Add to dashboard Cite

Summary Sex and age‐specific incidence rates of patients with treated end‐stage kidney disease (ESKD) in Australia are comparable to those in European countries, but substantially lower compared with those in the United States, Canada and many Asian countries. The incidence rates of treated ESKD in Australia increase with advancing age; however, the incidence of ESKD is likely to be underestimated because a proportion of patients with ESKD (about 50%) remain untreated. Late referral to nephrologists has reduced over the past decade, temporally associated with improved ESKD recognition. However, late referral still occurs in one in five Australians with ESKD. One in two Australians with ESKD has diabetes, with up to 35% of cases directly attributed to diabetes. Mortality rates for patients with ESKD remain substantially higher compared with the age‐matched general population, although there has been a significant improvement in survival over time. Cardiovascular disease and cancer are the two most common causes of death in patients with ESKD.

show abstract

“…Differences in the manifestation of illness and the experience of symptoms between men and women have been increasingly acknowledged (Ashuntantang et al, 2018;Barsky et al, 2001). 'Sex differences' generally refer to differing biological characteristics between males and females.…”

Section: Sex and Gender Differences In The Manifestation And Experience Of Symptomsmentioning

confidence: 99%

A continuous juggle of invisible forces: How fatigued dialysis patients manage daily life

et al. 2019

View full text Add to dashboard Cite

Dialysis patients commonly experience severe fatigue. Fatigue is known as an intrusive symptom strongly affecting perceived quality of life. A total of 23 interviews were conducted to explore how dialysis patients respond to fatigue symptoms and its consequences in daily life. A constructivist grounded theory approach guided data analysis and conceptualization of findings. Patients find themselves within a continuous decision loop, considering ones (physical) abilities and questioning ones normative beliefs and values. This inner process interacts with the outside world, and contains various ambiguities. Improved understanding of this demanding process could help to better address fatigue and positively contribute to the quality of life of dialysis patients.

show abstract

Kidneys and women's health: key challenges and considerations

Cited by 15 publications

References 64 publications

Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study

Preeclampsia and risk of end stage kidney disease: A Swedish nationwide cohort study

Impending challenges of the burden of end‐stage kidney disease in Australia

A continuous juggle of invisible forces: How fatigued dialysis patients manage daily life

Contact Info

Product

Resources

About