WHEELS OF DISPARITY: GENDER’S JOURNEY IN THE RENAL HUB AND SPOKE

Introduction:

Chronic Kidney Disease is a huge burden for the country. Out of 1.2 billion Indians, about 80 lakhs develop chronic kidney disease every year with approximately 200,000 new cases annually progressing to End stage kidney disease (ESKD), the majority requiring maintenance haemodialysis (MHD) as their primary renal replacement therapy. In response, the Government of India, through the Pradhan Mantri National Dialysis Program, and the Government of Telangana, via the Hub and Spoke Model, have established extensive dialysis networks. This study focuses on data from Tertiary care centre (Hub centre) and its 21 associated spoke centres, providing a detailed analysis of gender disparities in access to kidney health services and replacement therapies. 

This study aims to analyse the gender distribution of patients with kidney disorders undergoing renal replacement therapy and to assess the existing disparities between male and female patients.

Methods:

A cross-sectional study design was employed, collecting data from the Osmania General Hospital Hub and its 21 spoke centres. The study included demographic details, comorbidities, seropositivity rates, mortality, dropout rates, and patient statistics. Data sources included Continuous ambulatory peritoneal dialysis (CAPD) records, outpatient and inpatient records, biopsy records, and kidney transplant registries. Statistical analyses were performed with significance set at p < 0.05.

Results:

The hub centre operated with 18 machines, while the spoke centres combined operated 130 machines, mostly in four shifts, with the hub centre running five shifts daily. The doctor-to-patient ratio was 1:54, and the machine-to-patient ratio was 1:8.

Gender disparity results pertaining to MHD are highlighted in Table 1

Gender disparity results pertaining to peritoneal dialysis, outpatient services, inpatient services, kidney biopsy, kidney transplant recipient and donors are highlighted in Table 2

Conclusions:

The study highlights significant gender disparities in the diagnosis, treatment, and outcomes of patients with kidney disorders undergoing renal replacement therapy. The findings reveal that women are often underrepresented in receiving timely treatment, which may be due to a combination of biological, social, and healthcare access factors. Addressing these disparities requires targeted interventions to ensure equitable access to renal care for all patients, regardless of gender.

Hub and spoke model can be used to improve the equality of kidney care services between the genders. Future research should focus on understanding the underlying causes of these disparities and developing strategies to mitigate them, ultimately improving outcomes for both men and women with kidney disorder.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.