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It is a well-known fact in many medical specialities that diseases manifest in different ways according to gender. However, gender differences in kidney diseases have not been well-explored worldwide and especially in India. Differences could also be attributed to socio-cultural factors. Worldwide, though CKD is more prevalent in women, majority of men are initiated on kidney replacement therapy (KRT). We aimed to evaluate distinctions in hemodialysis-related attributes between genders in two state government-run hemodialysis centres in South India.
A cross-sectional observational study was conducted across two hemodialysis centers from South India. Data was collected from October 2022 to March 2023. All adult patients (>18 years) undergoing maintenance hemodialysis for a minimum period of 90 days were included in the study. Socio-demographic characteristics and laboratory parameters were recorded
The majority (72.7%) were males. There was no significant difference in the mean age group, marital status and the availability of caretakers for both. Spouses were the predominant caretakers for both sexes (64% for men and 51% for women, P=0.14). Sons cared more for mother patients than father patients (19.6% vs 8.8%, P=0.074). Men were significantly more educated than women (26.5% vs 17%, P=0.001). Diabetic nephropathy was the most common cause of ESKD in both (33.1% vs 31.3%, P=0.92). Men received higher mean HD sessions per week than women (2.8±0.4 vs 2.67±0.59, P=0.075). Mean haemoglobin ( 9.9±1.79 vs 9.46±1.47 g%, P=0.123) and mean serum creatinine (7.76±2.65 vs 6.41±2.27 mg/dl, P=0.002) were higher in men compared to women. Intradialytic complications such as hypotension and cramps were significantly more common in women (35.5%) than men (25%) (P=0.004). The majority of men were planning for a kidney transplant and were waitlisted compared to women (47.1% vs 43%, P=0.75). There was no significant difference in the average number of physician visits per month, average number of hospitalisations per month and HD vintage.
Care taker
Gender
Total
P Value
Male
Female
SPOUSE
174(64%)
52(51%)
226(60.4%)
0.147
SON
24(8.8%)
20(19.6%)
44(11.8%)
0.074+
MOTHER
18(6.6%)
6(5.9%)
24(6.4%)
1.000
DAUGHTER
16(5.9%)
In this study, men were more educated, received more sessions of HD, had better Hb and creatinine (surrogate for muscle mass) values and were well prepared for kidney transplant compared to women. Women suffering from CKD encounter numerous obstacles in everyday life, with the most significant inequalities appearing in social and economic arenas. To ensure equitable care for everyone with CKD, it's crucial to address not just clinical measures but also these gender-based social disparities.