Care trajectory differences in women and men with end-stage renal disease after dialysis initiation
Résumé
Few studies investigated sex-related differences in care consumption after dialysis initiation. Therefore, the aim of this study was to compare the care trajectory in the first year after dialysis start between men and women by taking into account the context of dialysis initiation. All patients who started dialysis in France in 2015 were included. Clinical data of patients and context of dialysis initiation were extracted from the Renal Epidemiology and Information Network (REIN) registry. Data on care consumption in the first year after dialysis start came from the French national health data system (SNDS): hospital stays <24h, hospital stays to prepare or maintain vascular access, hospital stays >24h for kidney problems and hospital stays >24h for other problems, and consultations with a general practitioner. Variables were compared between men and women with the χ2 test and Student’s or Welch t-test and logistic regression models were used to identify the factors associated with care consumption after dialysis start. The analysis concerned 8,856 patients (36% of women). Men were less likely to have a hospital stays >24h for kidney problems than women (OR = 0.8, 95% CI = [0.7–0.9]) and less general practitioner consultations (OR = 0.8, 95% CI = [0.8–0.9]), in the year after dialysis initiation, after adjustment on patient’s characteristics. Moreover, hospital stays for vascular access preparation or maintenance were longer in women than men (median duration: 2 days [0–2] vs. 1 day [0–2], p < 0.001). In conclusion, despite greater comorbidities in men, this study found few differences in post-dialysis care trajectory between men and women. Copyright: © 2023 Piveteau et al.
Mots clés
female
fistula
health care
hospitalization
human
International Classification of Diseases
major clinical study
male
retrospective study
vascular access
brachytherapy
chronic kidney failure
cognition
hemodialysis
kidney
Brachytherapy
Cognition
Female
Humans
Kidney
Kidney Failure, Chronic
Male
Renal Dialysis
hemoglobin
acute kidney failure
aged
albumin blood level
ambulatory care
Article
body mass
care trajectory difference
consultation
dialysis
end stage renal disease
estimated glomerular filtration rate
Domaines
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