Gender disparity in fistula use at initiation of hemodialysis varies markedly across ESRD networks—Analysis of USRDS data

Background: Gender disparities had been noted in the care of women with end stage renal disease (ESRD) in the early 2000's, including less frequent initiation of hemodialysis utilizing a fistula but more recent data have not been examined and underlying factors have not been extensively studied...

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Bibliographic Details
Published in:Hemodialysis international 2018-04, Vol.22 (2), p.168-175
Main Authors: Markell, Mariana, Brar, Amarpali, Stefanov, Dimitre G., Salifu, Moro O.
Format: Article
Language:English
Subjects:
AVF
dialysis
ESRD network
gender disparity
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Summary:Background: Gender disparities had been noted in the care of women with end stage renal disease (ESRD) in the early 2000's, including less frequent initiation of hemodialysis utilizing a fistula but more recent data have not been examined and underlying factors have not been extensively studied. Study design: Data from the United States Renal Data System (USRDS) were examined, including 202,999 hemodialysis patients. Only those who had received prior nephrology care were included. Multiple logistic regression was used, adjusted for possible confounders, including age, race, cause of ESRD, BMI, height, history of alcohol or drug abuse, medical comorbidities, ability to ambulate, time of nephrology care, type of insurance, and ESRD network. Results: The odds of arteriovenous fistula (AVF) use at initiation of hemodialysis were significantly lower in women compared to men (OR = 0.69, 95% CI 0.67‐0.71, P 
ISSN:1492-7535
1542-4758
DOI:10.1111/hdi.12579