Racial and Gender Differences in Quality of life Following Kidney Transplantation

Johnson, Corey; Wicks, Mona; Milstead, J.; Hartwig, Mary S.; Hathaway, Donna

doi:10.1111/j.1547-5069.1998.tb01266.x

Cited by 65 publications

(52 citation statements)

References 23 publications

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“…Meier-Kriesche et al [34], in a study using data from the US Transplant Scientific Registry and USRDS (1988 and 1997), concluded that female recipients had 10% increased chance of acute rejection (p < 0.001) during the first 6 months after transplantation; however, female recipients had 10% less chronic allograft failure compared to male recipients (p < 0.001). Other investigators found similar results [35,36,37]. …”

Section: Literature Reviewsupporting

confidence: 80%

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Kidney Transplantation and Gender Disparity

Jindal¹,

Ryan²,

Sajjad

et al. 2005

Am J Nephrol

152

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Gender inequity in access to hemodialysis and kidney transplantation has created a public health crisis in the US. Women have a lower chance of receiving hemodialysis and kidney transplant than men, but they constitute the majority of living kidney donors. Research has shown that economic factors such as greater income of men may encourage females to be donors; while gender-bias on part of physicians or institutions, lack of social support networks and differences in health-seeking behaviors compared to men are cited as reasons for this imbalance. We suggest various strategies to improve participation of women in the transplant process by education; raising awareness by publishing gender-specific data for dialysis and transplant centers; education and workshops to eliminate gender-bias within institutions and health-care providers and establishment of gender-specific support groups. Transplant teams that are more sensitive to the social complexities of women’s lives may lead to increased understanding of the effects of renal disease and indicate measures that need to be in place in order to address this gender disparity in the treatment of renal failure. Research needs to be done to elucidate the underlying medical, societal or psychological processes that lead to gender bias in the field of kidney transplantation.

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Section: Literature Reviewsupporting

confidence: 80%

“…This may explain why women often record a consistently lower quality of life than their male counterparts, particularly with regard to poor self-esteem and body image both before and after transplant [35, 48]. It remains to be seen if these aspects of behavior influence health care providers to list patients for a kidney transplant.…”

Section: Discussionmentioning

confidence: 99%

Kidney Transplantation and Gender Disparity

Jindal¹,

Ryan²,

Sajjad

et al. 2005

Am J Nephrol

152

View full text Add to dashboard Cite

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“…However, this difference, although statistically significant, is not considered to be clinically meaningful [16]. A difference of 2-3 points in the QLI scores has been associated with significant improvement in overall quality of life in studies assessing change in quality of life [23,24]. It is worth noting that previous studies differ from the present study with regard to the definition of CAM, with the present study specifically assessing the use of dietary supplements.…”

Section: Discussionmentioning

confidence: 68%

Self-reported quality of life in users and nonusers of dietary supplements in cancer

Lis

Cambron

Grutsch

et al. 2005

Support Care Cancer

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Contrary to some of the previously published research, this study, conducted at a community hospital comprehensive cancer center that combines alternative treatment approaches with conventional cancer care, found better self-reported QoL among the users of dietary supplements, as compared to nonusers. The next step in this research is to prospectively evaluate the patterns of changing QoL in relation to dietary supplement use across the entire duration of cancer diagnosis and treatment.

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“…This report discounted the poor HLA matching for African American patients suggested in earlier reports (40,41), and concluded that non-HLA mechanisms must contribute to the poor renal transplant outcomes in African American patients. The higher rates of acute rejection and graft failure in African American patients result in a poorer quality of life for African American transplant patients (42). These observations about African American patients and poor renal transplant outcomes have now been extended to pediatric (43) and adult liver transplantation (44), and to pediatric heart transplantation (45).…”

Section: Discussionmentioning

confidence: 96%

Tacrolimus Dosing in Pediatric Heart Transplant Patients is Related to CYP3A5 and MDR1 Gene Polymorphisms

Zheng

Webber

Zeevi

et al. 2003

American Journal of Transplantation

248

174

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Tacrolimus is a substrate for P-glycoprotein (P-gp) and cytochrome (CYP) P4503A. P-gp is encoded by the multiple drug resistance gene MDR1 and CYP3A is the major enzyme responsible for tacrolimus metabolism. Both MDR1 and CYP3A5 genes have multiple single nucleotide polymorphisms. The objective of this study was to evaluate whether the MDR1 exon21 and exon26 polymorphisms and the CYP3A5 polymorphism are associated with tacrolimus disposition in pediatric heart transplant patients. At 3, 6 and 12 months post transplantation, a significant difference in tacrolimus blood level per dose/kg/day was found between the CYP3A5 *1/*3 (CYP3A5 expressor) vs. *3/*3 (nonexpressor) genotypes with the *1/*3 patients requiring a larger tacrolimus dose to maintain the same blood concentration. There were no significant differences in tacrolimus blood level per dose/kg/day between MDR1 exon21 G2677T and exon 26 C3435T at 3 months, but both were found to have a significant association with tacrolimus blood level per dose/kg/day at 6 and 12 months. We conclude that specific genotypes of MDR1 and CYP3A5 in pediatric heart transplant patients require larger tacrolimus doses to maintain their tacrolimus blood concentration, and that this information could be used prospectively to manage patient's immunosuppressive therapy.

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Racial and Gender Differences in Quality of life Following Kidney Transplantation

Abstract: Although transplantation dramatically improves QoL, some segments of the patient population, namely African-Americans and women, do not benefit to the same extent as others. Nurses need to recognize sociocultural differences in patients and how these differences affect care requirements.

Cited by 65 publications

References 23 publications

Kidney Transplantation and Gender Disparity

Kidney Transplantation and Gender Disparity

Self-reported quality of life in users and nonusers of dietary supplements in cancer

Tacrolimus Dosing in Pediatric Heart Transplant Patients is Related to CYP3A5 and MDR1 Gene Polymorphisms

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