Advertisement

Psychosocial and Quality of Life Issues in Women With End-Stage Renal Disease

  • Susie Q. Lew
    Correspondence
    Address correspondence to Susie Q. Lew, MD, FACP, FASN, 2150 Pennsylvania Avenue NW, Suite 1-200, Washington, DC 20037.
    Affiliations
    Department of Medicine, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC.
    Search for articles by this author
  • Samir S. Patel
    Affiliations
    Department of Medicine, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC.
    Search for articles by this author
      There are differences in the way men and women experience end-stage renal disease (ESRD). Women are more likely to shoulder much of the burden of adapting family environments to accommodate life with ESRD. Issues such as fertility and conception are different from women in the general population. In the ESRD population, women express more depressive affect, anxiety, and personality disorder than men. Several psychosocial parameters have been found to be linked with differential survival between men and women such as social support and marital satisfaction. Women are more likely to serve as living donors for kidney transplantation yet less likely to be recipients of a cadaveric or living kidney transplant. We review the available literature on gender differences in ESRD with a focus on chronic hemodialysis.

      Index Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Advances in Chronic Kidney Disease
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Mapes D.L.
        • Lopes A.A.
        • Satayathum S.
        • et al.
        Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS).
        Kidney Int. 2003; 64: 339-349
      1. USRDS: 2006 Annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States.
        Am J Kidney Dis. 2007; 49: S1-S296
        • Silbiger S.R.
        • Neugarten J.
        The impact of gender on the progression of chronic renal disease.
        Am J Kidney Dis. 1995; 25: 515-533
        • Silbiger S.R.
        • Neugarten J.
        The role of gender in the progression of renal disease.
        Adv Ren Replace Ther. 2003; 10: 3-14
        • Neugarten J.
        • Acharya A.
        • Silbiger S.R.
        Effect of gender on the progression of nondiabetic renal disease: A meta-analysis.
        J Am Soc Nephrol. 2000; 11: 319-329
        • Seliger S.L.
        • Davis C.
        • Stehman-Breen C.
        Gender and the progression of renal disease.
        Curr Opin Nephrol Hypertens. 2001; 10: 219-225
        • Neugarten J.
        • Silbiger S.R.
        Effects of sex hormones on mesangial cells.
        Am J Kidney Dis. 1995; 26: 147-151
        • Kwan G.
        • Neugarten J.
        • Sherman M.
        • et al.
        Effects of sex hormones on mesangial cell proliferation and collagen synthesis.
        Kidney Int. 1996; 50: 1173-1179
        • Neugarten J.
        • Acharya A.
        • Lei J.
        • et al.
        Selective estrogen receptor modulators suppress mesangial cell collagen synthesis.
        Am J Physiol. 2000; 279: F309-F318
        • Silbiger S.
        • Lei J.
        • Neugarten J.
        Estradiol suppresses type I collagen synthesis in mesangial cells via activation of activator protein-1.
        Kidney Int. 1999; 55: 1268-1276
        • Silbiger S.
        • Lei J.
        • Ziyadeh F.N.
        • et al.
        Estradiol reverses TGF-beta1-stimulated type IV collagen gene transcription in murine mesangial cells.
        Am J Physiol. 1998; 274: F1113-F1118
        • Lei J.
        • Silbiger S.
        • Ziyadeh F.N.
        • et al.
        Serum-stimulated alpha 1 type IV collagen gene transcription is mediated by TGF-beta and inhibited by estradiol.
        Am J Physiol. 1998; 274: F252-F258
        • Bloembergen W.E.
        • Port F.K.
        • Mauger E.A.
        • et al.
        Causes of death in dialysis patients: Racial and gender differences.
        J Am Soc Nephrol. 1994; 5: 1231-1242
        • Depner T.
        • Daugirdas J.
        • Greene T.
        • et al.
        Dialysis dose and the effect of gender and body size on outcome in the HEMO Study.
        Kidney Int. 2004; 65: 1386-1394
        • Cukor D.
        • Peterson R.A.
        • Cohen S.D.
        • et al.
        Depression in end-stage renal disease hemodialysis patients.
        Nat Clin Pract Nephrol. 2006; 2: 678-687
        • Kimmel P.L.
        • Peterson R.A.
        Depression in patients with end-stage renal disease treated with dialysis: Has the time to treat arrived?.
        Clin J Am Soc Nephrol. 2006; 1: 349-352
        • Kimmel P.L.
        Depression in patients with chronic renal disease: What we know and what we need to know.
        J Psychosom Res. 2002; 53: 951-956
        • Kimmel P.L.
        Psychosocial factors in dialysis patients.
        Kidney Int. 2001; 59: 1599-1613
        • Kimmel P.L.
        • Peterson R.A.
        • Weihs K.L.
        • et al.
        Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients.
        Kidney Int. 1998; 54: 245-254
        • Israel M.
        Depression in dialysis patients: A review of psychological factors.
        Can J Psychiatry. 1986; 31: 445-451
        • Finkelstein F.O.
        • Finkelstein S.H.
        Depression in chronic dialysis patients: Assessment and treatment.
        Nephrol Dial Transplant. 2000; 15: 1911-1913
        • Lopes A.A.
        • Bragg-Gresham J.L.
        • Satayathum S.
        • et al.
        Health-related quality of life and associated outcomes among hemodialysis patients of different ethnicities in the United States: The Dialysis Outcomes and Practice Patterns Study (DOPPS).
        Am J Kidney Dis. 2003; 41: 605-615
        • Evans R.W.
        • Manninen D.L.
        • Garrison Jr, L.P.
        • et al.
        The quality of life of patients with end-stage renal disease.
        N Engl J Med. 1985; 312: 553-559
        • Akman B.
        • Ozdemir F.N.
        • Sezer S.
        • et al.
        Depression levels before and after renal transplantation.
        Transplant Proc. 2004; 36: 111-113
        • Finkelstein F.O.
        • Finkelstein S.H.
        • Steele T.E.
        Assessment of marital relationships of hemodialysis patients.
        Am J Med Sci. 1976; 271: 21-28
        • Steele T.E.
        • Finkelstein S.H.
        • Finkelstein F.O.
        Marital discord, sexual problems, and depression.
        J Nerv Ment Dis. 1976; 162: 225-237
        • Kimmel P.L.
        • Emont S.L.
        • Newmann J.M.
        • et al.
        ESRD patient quality of life: Symptoms, spiritual beliefs, psychosocial factors, and ethnicity.
        Am J Kidney Dis. 2003; 42: 713-721
        • Kimmel P.
        Just whose quality of life is it anyway?.
        Kidney Int. 2000; 57: 113-120
        • Bloembergen W.E.
        • Port F.K.
        • Mauger E.A.
        • et al.
        Gender discrepancies in living related renal transplant donors and recipients.
        J Am Soc Nephrol. 1996; 7: 1139-1144
        • Kimmel P.L.
        • Thamer M.
        • Richard C.M.
        • et al.
        Psychiatric illness in patients with end stage renal disease.
        Am J Med. 1998; 105: 214-221
        • Kimmel P.L.
        • Patel S.S.
        • Peterson R.A.
        Depression in African-American patients with kidney disease.
        J Natl Med Assoc. 2002; 94: 92S-103S
        • Lim V.S.
        • Henriquez C.
        • Sievertsen G.
        • et al.
        Ovarian function in chronic renal failure: Evidence suggesting hypothalamic anovulation.
        Ann Intern Med. 1980; 93: 21-27
        • Schmidt R.J.
        • Holley J.L.
        Fertility and contraception in end-stage renal disease.
        Adv Ren Replace Ther. 1998; 5: 38-44
        • Palmer B.F.
        Sexual dysfunction in uremia.
        J Am Soc Nephrol. 1999; 10: 1381-1388
        • Okundaye I.
        • Abrinko P.
        • Hou S.
        Registry of pregnancy in dialysis patients.
        Am J Kidney Dis. 1998; 31: 766-773
        • Hou S.H.
        Pregnancy in women on haemodialysis and peritoneal dialysis.
        Baillieres Clin Obstet Gynaecol. 1994; 8: 481-500
        • Binik Y.M.
        • Mah K.
        Sexuality and end-stage renal disease: Research and clinical recommendations.
        Adv Ren Replace Ther. 1994; 1: 198-209
        • Hou S.
        Pregnancy in chronic renal insufficiency and end-stage renal disease.
        Am J Kidney Dis. 1999; 33: 235-252
        • Le Ray C.
        • Coulomb A.
        • Elefant E.
        • et al.
        Mycophenolate mofetil in pregnancy after renal transplantation: A case of major fetal malformations.
        Obstet Gynecol. 2004; 103: 1091-1094
        • Sifontis N.M.
        • Coscia L.A.
        • Constantinescu S.
        • et al.
        Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus.
        Transplantation. 2006; 82: 1698-1702
        • Tjeertes I.F.
        • Bastiaans D.E.
        • van Ganzewinkel C.J.
        • et al.
        Neonatal anemia and hydrops fetalis after maternal mycophenolate mofetil use.
        J Perinatol. 2007; 27: 62-64
        • Kaveh K.
        • Kimmel P.L.
        Compliance in hemodialysis patients: Multidimensional measures in search of a gold standard.
        Am J Kidney Dis. 2001; 37: 244-266
        • Leggat Jr, J.E.
        • Orzol S.M.
        • Hulbert-Shearon T.E.
        • et al.
        Noncompliance in hemodialysis: Predictors and survival analysis.
        Am J Kidney Dis. 1998; 32: 139-145
        • Bunzel B.
        • Laederach-Hofmann K.
        Solid organ transplantation: Are there predictors for posttransplant noncompliance?.
        Transplantation. 2000; 70: 711-716
        • Kiley D.J.
        • Lam C.S.
        • Pollak R.
        A study of treatment compliance following kidney transplantation.
        Transplantation. 1993; 55: 51-56
        • Yavuz A.
        • Tuncer M.
        • Erdogan O.
        • et al.
        Is there any effect of compliance on clinical parameters of renal transplant recipients?.
        Transplant Proc. 2004; 36: 120-121
        • Kiecolt-Glaser J.K.
        • Newton T.
        • Cacioppo J.T.
        • et al.
        Marital conflict and endocrine function: Are men really more physiologically affected than women?.
        J Consult Clin Psychol. 1996; 64: 324-332
        • Chowanec G.D.
        • Binik Y.M.
        End stage renal disease and the marital dyad: An empirical investigation.
        Soc Sci Med. 1989; 28: 971-983
        • Devins G.M.
        • Beanlands H.
        • Mandin H.
        • et al.
        Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease.
        Health Psychol. 1997; 16: 529-538
        • Moguilner M.E.
        • Bauman A.
        • De-Nour A.K.
        Adjustment of children and parents to chronic hemodialysis.
        Psychosomatics. 1988; 29: 289-294
        • Daneker B.
        • Kimmel P.L.
        • Ranich T.
        • et al.
        Depression and marital dissatisfaction in patients with end-stage renal disease and in their spouses.
        Am J Kidney Dis. 2001; 38: 839-846
        • Turner-Musa J.
        • Leidner D.
        • Simmens S.
        • et al.
        Family structure and patient survival in an African-American end-stage renal disease population: A preliminary investigation.
        Soc Sci Med. 1999; 48: 1333-1340
        • Kimmel P.L.
        • Peterson R.A.
        • Weihs K.L.
        • et al.
        Dyadic relationship conflict, gender, and mortality in urban hemodialysis patients.
        J Am Soc Nephrol. 2000; 11: 1518-1525
        • Gaylin D.S.
        • Held P.J.
        • Port F.K.
        • et al.
        The impact of comorbid and sociodemographic factors on access to renal transplantation.
        JAMA. 1993; 269: 603-608
        • Kjellstrand C.M.
        Age, sex, and race inequality in renal transplantation.
        Arch Intern Med. 1988; 148: 1305-1309
        • Kayler L.K.
        • Meier-Kriesche H.U.
        • Punch J.D.
        • et al.
        Gender imbalance in living donor renal transplantation.
        Transplantation. 2002; 73: 248-252
        • Schaubel D.E.
        • Stewart D.E.
        • Morrison H.I.
        • et al.
        Sex inequality in kidney transplantation rates.
        Arch Intern Med. 2000; 160: 2349-2354
        • Wolfe R.A.
        • Ashby V.B.
        • Milford E.L.
        • et al.
        Differences in access to cadaveric renal transplantation in the United States.
        Am J Kidney Dis. 2000; 36: 1025-1033
        • Garg P.P.
        • Furth S.L.
        • Fivush B.A.
        • et al.
        Impact of gender on access to the renal transplant waiting list for pediatric and adult patients.
        J Am Soc Nephrol. 2000; 11: 958-964
        • Alexander G.C.
        • Sehgal A.R.
        Barriers to cadaveric renal transplantation among blacks, women, and the poor.
        JAMA. 1998; 280: 1148-1152
        • Zimmerman D.
        • Donnelly S.
        • Miller J.
        • et al.
        Gender disparity in living renal transplant donation.
        Am J Kidney Dis. 2000; 36: 534-540
        • Reyes D.
        • Lew S.Q.
        • Kimmel P.L.
        Gender differences in hypertension and kidney disease.
        Med Clin North Am. 2005; 89: 613-630
        • Kimmel P.L.
        • Patel S.S.
        Psychosocial issues in women with renal disease.
        Adv Ren Replace Ther. 2003; 10: 61-70
        • Ojo A.
        • Port F.K.
        Influence of race and gender on related donor renal transplantation rates.
        Am J Kidney Dis. 1993; 22: 835-841
        • Wolfe R.A.
        • Ashby V.B.
        • Milford E.L.
        • et al.
        Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.
        N Engl J Med. 1999; 341: 1725-1730
        • Mange K.C.
        • Joffe M.M.
        • Feldman H.I.
        Effect of the use or nonuse of long-term dialysis on the subsequent survival of renal transplants from living donors.
        N Engl J Med. 2001; 344: 726-731
        • Meier-Kriesche H.U.
        • Ojo A.O.
        • Leavey S.F.
        • et al.
        Gender differences in the risk for chronic renal allograft failure.
        Transplantation. 2001; 71: 429-432