Gender Disparities in Access to Kidney Transplant: Inequities in the Inequity

Vinson, Amanda J.

doi:10.1016/j.ekir.2022.03.034

Cited by 15 publications

(19 citation statements)

References 9 publications

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“…We do not have data on other gender differences described by other authors in female recipients, such as lower rates of pre-transplant medical screening, lower access to the waiting list, longer waiting list retention, or lower rates of kidney transplantation from deceased or living donors in women ( 4 , 21 – 25 ). In our series, we found no differences in dialysis modality, although preemptive transplantation was less common in women.…”

Section: Discussionmentioning

confidence: 88%

Graft survival differences in kidney transplants related to recipient sex and age

et al. 2022

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BackgroundIn recent years, there has been increasing interest in studying differences in recipient sex in renal disease treatment, access to renal replacement therapy, and subsequent outcomes. Our aim was to find out whether there are differences in outcomes after renal transplantation between female and male kidney transplant recipients in our series, particularly in adults under 60 years of age during long-term follow-up.MethodsThis was a retrospective study of our kidney transplant series (n = 1,101) to compare graft survival depending on the sex of the recipient in the entire series and patients < 60 years of age (n = 687) during long-term follow-up.ResultsWe observed no association between recipient sex and graft survival throughout the series, regardless of recipient sex. However, adult female recipients under 60 years of age had lower graft survival than male recipients (p = 0.040). Pre-transplant sensitization (HR 2.438, p = 0.002) and donor age (HR: 1.021, p = 0.017) were the independent variables associated with graft failure.ConclusionFemale recipients younger than 60 years of age had lower graft survival than male recipients, although there were no gender differences in graft or patient survival in the overall study population. Recipient sex per se was not related to graft failure, but the greater immunological risk in women and more frequent use of expanded criteria donors in female recipients under 60 years of age were the main factors related to their poorer graft survival. Further studies and new strategies are needed to identify these differences and develop the best approach to address them.

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Section: Discussionmentioning

confidence: 88%

Graft survival differences in kidney transplants related to recipient sex and age

et al. 2022

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“…Females are generally more risk averse and might be less likely to advocate for themselves towards a kidney transplant. 65 Females might preferentially donate their kidneys in order not to disrupt economic stability in families where males might remain as the primary breadwinners. Females might also perceive donating a kidney to their husbands or children as part of their nurturing role.…”

Section: Biological and Psychosocial Factors Contributing To Disparit...mentioning

confidence: 99%

“…Female patients might also be more likely to report minor and major health complaints resulting in both lower self‐reported and provider‐perceived health and subsequent potential benefit from kidney transplant. Females are generally more risk averse and might be less likely to advocate for themselves towards a kidney transplant 65 . Females might preferentially donate their kidneys in order not to disrupt economic stability in families where males might remain as the primary breadwinners.…”

Section: Introductionmentioning

confidence: 99%

Sex and gender disparity in kidney transplantation: Historical and future perspectives

Salas

Chua²,

Rossi³

et al. 2022

Clinical Transplantation

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Sex and gender disparity exist in various stages of kidney transplantation. Females were found to be less likely to be referred for kidney transplant, complete pretransplant evaluation, be placed on the waitlist, and receive a kidney transplant compared to their male counterparts. Interestingly, females comprise the majority of living kidney donors. This review explores the biological and psychosocial factors that contribute to sex and gender disparity in kidney transplantation and proposes ways to address the disparity.

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“…, because of pregnancy), age, comorbidity or frailty, and body size, that interact with gender. 2,15–21…”

Section: Introductionmentioning

confidence: 99%

“…In general, it is estimated that women are 10%-20% less likely to receive kidney transplantation compared with men, with the gap increasing with age. 1 Disproportionately less women are referred for transplantation, waitlisted, or receive a deceased donor kidney transplant than men, and most living kidney donors are women, [2][3][4][5][6] which is compounded further in marginalized groups because of ethnic, sociocultural, education, and financial factors. [7][8][9] Poor access to kidney transplantation among women with kidney failure is associated with worse survival and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Perspectives of Nephrologists on Gender Disparities in Access to Kidney Transplantation

Natale

Hecking

Kurnikowski

et al. 2023

CJASN

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Background: Gender disparities in access to kidney transplantation are apparent with women being up to 20% less likely to receive kidney transplant compared to men across different settings and socioeconomic backgrounds. We aimed to describe nephrologists’ perspectives on gender disparities in access to kidney transplantation. Methods: Fifty-one nephrologists (55% women) from 22 countries participated in semi-structured interviews from October 2019 to April 2020. We analyzed the transcripts thematically. Results: We identified three themes: caregiving as a core role (coordinators of care for partners; fulfilling family duties over own health; maternal protectiveness; and inherent willingness and generosity), stereotyping and stigma (authority held by men in decision-making; protecting the breadwinner; preserving body image and appearance; and safeguard fertility), social disadvantage and vulnerability (limited information and awareness; coping alone and lack of support; disempowered by language barriers; lack of financial resources; and without access to transport). Conclusions: Gender disparities in access to kidney transplantation are perceived by nephrologists to be exacerbated by gender norms and values, stigma and prejudice, and educational and financial disadvantage that are largely encountered by women compared with men across different socioeconomic settings.

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Gender Disparities in Access to Kidney Transplant: Inequities in the Inequity

Cited by 15 publications

References 9 publications

Graft survival differences in kidney transplants related to recipient sex and age

Graft survival differences in kidney transplants related to recipient sex and age

Sex and gender disparity in kidney transplantation: Historical and future perspectives

Perspectives of Nephrologists on Gender Disparities in Access to Kidney Transplantation

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