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Age and comorbidities are effect modifiers of gender disparities in renal transplantation.

Publication ,  Journal Article
Segev, DL; Kucirka, LM; Oberai, PC; Parekh, RS; Boulware, LE; Powe, NR; Montgomery, RA
Published in: J Am Soc Nephrol
March 2009

Women have less access to kidney transplantation than men, but the contributions of age and comorbidity to this disparity are largely unknown. We conducted a national cohort study of 563,197 patients with first-onset ESRD between 2000 and 2005. We used multivariate generalized linear models to evaluate both access to transplantation (ATT), defined as either registration for the deceased-donor waiting list or receiving a live-donor transplant, and survival benefit from transplantation, defined as the relative rate of survival after transplantation compared with the rate of survival on dialysis. We compared relative risks (RRs) between women and men, stratified by age categories and the presence of common comorbidities. Overall, women had 11% less ATT than men. When the model was stratified by age, 18- to 45-yr-old women had equivalent ATT to men (RR 1.01), but with increasing age, ATT for women declined dramatically, reaching a RR of 0.41 for those who were older than 75 yr, despite equivalent survival benefits from transplantation between men and women in all age subgroups. Furthermore, ATT for women with comorbidities was lower than that for men with the same comorbidities, again despite similar survival benefits from transplantation. This study suggests that there is no disparity in ATT for women in general but rather a marked disparity in ATT for older women and women with comorbidities. These disparities exist despite similar survival benefits from transplantation for men and women regardless of age or comorbidities.

Duke Scholars

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

March 2009

Volume

20

Issue

3

Start / End Page

621 / 628

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • Urology & Nephrology
  • United States
  • Tissue and Organ Procurement
  • Sex Characteristics
  • Prejudice
  • Patient Selection
  • Multivariate Analysis
  • Middle Aged
 

Citation

APA
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Segev, D. L., Kucirka, L. M., Oberai, P. C., Parekh, R. S., Boulware, L. E., Powe, N. R., & Montgomery, R. A. (2009). Age and comorbidities are effect modifiers of gender disparities in renal transplantation. J Am Soc Nephrol, 20(3), 621–628. https://doi.org/10.1681/ASN.2008060591
Segev, Dorry L., Lauren M. Kucirka, Pooja C. Oberai, Rulan S. Parekh, L Ebony Boulware, Neil R. Powe, and Robert A. Montgomery. “Age and comorbidities are effect modifiers of gender disparities in renal transplantation.J Am Soc Nephrol 20, no. 3 (March 2009): 621–28. https://doi.org/10.1681/ASN.2008060591.
Segev DL, Kucirka LM, Oberai PC, Parekh RS, Boulware LE, Powe NR, et al. Age and comorbidities are effect modifiers of gender disparities in renal transplantation. J Am Soc Nephrol. 2009 Mar;20(3):621–8.
Segev, Dorry L., et al. “Age and comorbidities are effect modifiers of gender disparities in renal transplantation.J Am Soc Nephrol, vol. 20, no. 3, Mar. 2009, pp. 621–28. Pubmed, doi:10.1681/ASN.2008060591.
Segev DL, Kucirka LM, Oberai PC, Parekh RS, Boulware LE, Powe NR, Montgomery RA. Age and comorbidities are effect modifiers of gender disparities in renal transplantation. J Am Soc Nephrol. 2009 Mar;20(3):621–628.

Published In

J Am Soc Nephrol

DOI

EISSN

1533-3450

Publication Date

March 2009

Volume

20

Issue

3

Start / End Page

621 / 628

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • Urology & Nephrology
  • United States
  • Tissue and Organ Procurement
  • Sex Characteristics
  • Prejudice
  • Patient Selection
  • Multivariate Analysis
  • Middle Aged