Women tend to lose more expected years of life than men following a diagnosis of kidney failure, according to a new study published in the journal The BMJ.
Kidney failure — also known as end-stage kidney disease — happens when chronic kidney disease progresses to a point where the kidneys can no longer filter waste products form the blood well enough to sustain life. In order to stay alive, a person must undergo dialysis — a process in which (most commonly) a machine filters waste products from the blood, usually for several hours three times each week. For some people, a kidney transplant may also be an option following kidney failure — but long waiting times for donor kidneys usually mean it’s necessary to undergo dialysis for some time before undergoing a transplant. Many people with diabetes and kidney failure, though — especially if they’re older and have other serious health problems — are not considered candidates for a kidney transplant due to the risks involved in the surgery. Instead, they must undergo dialysis indefinitely. Diabetes is a leading cause of chronic kidney disease, due to the damaging effects of high blood glucose on the filtering units of the kidneys (nephrons) over time.
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For the latest study, researchers at the University of Sydney in Australia looked at health records from 82,844 people with kidney failure in Australia and New Zealand. These records spanned over 30 years, and included 33,329 women (40% of participants) and 49,555 men (60% of participants). During a follow-up period of 536,602 person-years — an average of 6.5 years per person — 49,376 participants (60%) died. These deaths were almost evenly distributed between men and women — 20,099 women in the study died (60% of women), while 29,277 men in the study died (59% of men).
Kidney failure increases death risk more in women than in men
But when the researchers compared women and men in the study with people in the general population, they found that having kidney failure increased the risk for death in women by more than it did in men. Based on data from the general population, if the 33,329 women in the study hadn’t had kidney failure, one would expect there to be 1,781 deaths during the follow-up period. Instead, there were 20,099 deaths — meaning that having kidney failure increased the risk of dying by a factor of 11.3. If the 49,555 men in the study hadn’t had kidney failure, one would expect there to be 4,272 deaths during the follow-up period. Instead, there were 29,277 deaths — meaning that having kidney failure increased the risk of dying by a factor of 6.9. If women in the study had experienced the same increased risk of death linked to kidney failure as men, there would have been 12,206 deaths during the follow-up period — instead of the 20,099 that actually occurred.
In other words, among people with kidney failure, being a women was linked to a 65% higher risk of dying, compared with women and men without kidney failure. This translated into an additional 3.6 years of life lost, on average, from having kidney failure in women compared with having kidney failure in men. No major differences were seen in the risk of death between different types of dialysis (standard hemodialysis, or a less common method called peritoneal dialysis). Receiving a kidney transplant somewhat reduced the disparity in added death risk between men and women, but didn’t eliminate it — women who received a transplant lost an average of 2.3 more years of life than their male counterparts, compared with women and men without kidney failure.
“Compared with the general population, female patients” with kidney failure “had greater excess deaths, worse relative survival, and more years of life lost than male patients,” the researchers concluded. “Future research should investigate whether systematic differences exist in access to care and possible strategies to mitigate excess mortality among female patients.”
Want to learn more about keeping your kidneys healthy with diabetes? Read “Managing Diabetic Kidney Disease,” “How to Keep Your Kidneys Healthy,” “Protecting Your Kidneys,” and “Kidney Disease: Your Seven-Step Plan for Prevention.”