More women die from kidney failure than men
Women face a greater risk for mortality than men following kidney failure, according to a study published in The BMJ.
Female patients had greater excess deaths, worse relative survival and more years of life lost compared with male patients, the researchers said, and these differences exceed similar disparities seen in cardiovascular disease and cancer.
“The fact we’ve got more women dying form kidney failure before their time than men, that’s what is really crucial,” author Nicole L. De La Mata, PhD, a biostatistician at the University of Sydney School of Public Health, said in a university press release. “We need to work out the reason for this difference, whether it relates to how people access health care, the treatment they get or biological considerations.”
The researchers examined health records for 82,844 patients with kidney failure, including 49,555 men (60%) and 33,329 women (40%) who were enrolled in the Australian and New Zealand Dialysis and Transplant Registry between 1980 and 2019, and then linked these records with national death registers recording deaths and their causes in both countries.
According to the findings, women with kidney failure were more likely to die prematurely of all causes than men with kidney failure, losing on average 3.6 years more life than men. Also, women experienced 11 times the expected deaths, compared with seven times in men.
The impact was different based on the age when the patient experienced kidney failure, as younger women saw the greatest loss in life expectancy and survival. A girl aged 15 years will lose on average 33 years of life compared with what is expected in the general population, whereas a similarly aged male with kidney failure would lose 27 years.
The researchers said their study was unique because it compares survival with what would be expected in the general population instead of just between patients with kidney failure.
“It tells a more personal story for people with kidney disease. The analysis really illustrates how they are missing out on more years of life, compared to life expectancy in the general population,” said De La Mata.
Females generally live longer than males because of biology and other reasons, the researchers said. Chronic kidney disease is more prevalent in women, but men progress to kidney failure faster, and most kidney failures are experienced by men. Yet this survival advantage is entirely lost for women with kidney failure, the researchers said.
“No one has ever really realized the extent of the disadvantage for women with kidney disease before,” Angela C. Webster, MBBS, MM (Clin Epi), PhD, FRCP (UK), FRACP, professor of clinical epidemiology at the School of Public Health, said in the release.
The findings add to a growing pool of equity research and awareness examining disparities in health and health care, the researchers said.
“The reason for these sex differences needs further exploration. It could be due to biological reasons or differential health care access or treatment,” said De La Mata.
Many chronic diseases have sex-specific mechanisms in which women may not develop the same symptoms as men, so illnesses go unrecognized, the researchers said, which also leads to systematic differences in care.
Also, other studies have shown that women have worse access to health care than men, Webster said, such as how women are treated for cardiovascular diseases at a later stage of illness and may have delayed access to better treatment.
“There is a need to identify differences in access to health care and strategies to close any gap,” Webster said.