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ESRD shows significant differences between both sexes in relation to incidence, prevalence, evolution and treatment, whether it is some dialysis technique or kidney transplantation in Argentina as well as in other parts of the world. Changing the paradigm from a gender perspective would be the initial step to identify not only the biological causes (non modifiable) but those related to sociocultural and economic factors related to the female/male sex, which can be modified to equalize the conditions before kidney disease and the course of it.
Retrospective analysis of the results of the Argentine Chronicle Dialysis Registry report 2021 (SMarinovich and others) in relation to variations in incidence, prevalence, mortality and kidney transplantation in men and women of the 29408 patients on dialysis in Argentina during 2020.
INCIDENCE: 2020 incidence rates fell to unprecedented values (Covid effect), however men maintain supremacy with 151 vs 95 pmp in the female population. Incidence rates are similar until the age of 30, while men maintain a higher incidence from de age of 40, with 2,5% more in men in the +65 group. PREVALENCE: In Argentina the prevalence of ESRD is 765 pmp for men, and 536 pmp for women, with increasing gaps in favour of the male sex as the age of the patients progresses, being almost similar in the age group 20 years. Both sexes showed a drop in 2020 (Covid effect). SURVIVAL: in the multivariate analysis, sex was no decisive for patient´s survival such as age at admission, CHF, cerebral vascular pathology and peripheral vascular pathology among others. MORTALITY: The gross age group rate of women and men are similar. Between 2020 and 2021 there was a greater increase in groups +65 and 45-65 years, in both sexes in similar proportions (covid effect). The gross mortality rate increase to 20.35 deaths x 100 P/YRE. Men had higher gross mortality than women in all years from 2005 to 2020, but when we compare by standardizing by age and aetiologY (SMR), adjusted mortaqlity rates of men are significantly higher than those of women in the last 6 years. KIDNEY TRANSPLANTATION : the crude rate of kidney transplants in the population in Chronic Dialysis decreased from 4.89 to 2.51 transplants per 100 P/YRE between 2019 and 2020 (Covid effect). Since 2005 , the transplant rate of women has never been significantly higher than that of men, on the other hand, men had a significant higher transplant rate from 2010 untill 2018. The growth observed between crude and adjusted rate is due to the fact that there is a higher prevalence in Chronic Dialysys of gerontes and diabetics in the subpopulation of Males. When adjusted for Age and Aetiology (SMR), Men have significantly higher kidney transplantation rates than those of women in the last 8 years. The average waiting time for kidney transplantation shows a difference in favour of male population , with an average of 44,6 months of waiting, while women wait 53,2 months, being more evident in the age group +65 years. In relation to live donor transplant, in Argentina the vast majority of donors are women , with a greater number of males recipients. In adittion, the accessibility to transplantation in women +65 years is very low.