Women's Access to Kidney Transplantation

• Type of Material: Article
• Authors: Jessica L. Harding, Emory University
• Language: English
• Date: 2024-01-27
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2024 International Society of Nephrology. Published by Elsevier Inc.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.ekir.2024.01.040
• Title of Journal or Parent Work: KIDNEY INTERNATIONAL REPORTS
• Volume: 9
• Issue: 3
• Start Page: 512
• End Page: 515
• Grant/Funding Agency: Emory University; American Society of Transplantation
• Grant/Funding Information: This work was funded in part by an Emory University Health Services Center Pilot Award (recipient: JLH) and an American Society of Transplantation Career Development Award (recipient: JLH).
• Keywords: hospitalization; kidney failure; donor shortage; women; quality of life; cost of care; transplantation; survival; dialysis; chronic kidney disease
• Research Categories: Surgery; Gender studies; Health care management

Abstract

Kidney transplantation is the ideal treatment for people with kidney failure because it offers longer survival, better quality of life, reduced hospitalization, and lower cost relative to dialysis.1 However, a relative donor shortage means not all kidney failure patients will receive a lifesaving transplant, and it is in this setting that sex and gender disparities in access remain prevalent. Women have a higher prevalence of chronic kidney disease (CKD); however, they are less likely to receive appropriate care and initiate dialysis than men.2,3 Women are less likely to be referred, evaluated, or waitlisted for a kidney transplant, and less likely to receive a live donor kidney transplant despite being more likely to be a donor.2,3 Reasons for this disparity are unclear, but likely include a combination of conscious and unconscious provider bias, differential comorbidity burden or frailty distribution, possible differences in candidate self-selection, caregiving burden, as well as biological factors such as pregnancy-induced sensitization.2,3 This article reviews key evidence documenting sex and gender disparities at multiple steps of the transplant care continuum, from CKD care through to transplant.