Renal replacement therapy (RRT) is a life-saving treatment for individuals with end-stage renal disease. It involves the use of dialysis or a kidney transplant to replace the function of the kidneys.

However, gender differences have been noted in the incidence, prevalence, and outcomes of RRT. This systematic review aims to investigate the impact of gender on RRT and its outcomes.

Methodology

A systematic literature review was conducted using PubMed and Embase databases.

The search terms included “renal replacement therapy,” “dialysis,” “kidney transplant,” “gender,” “male,” and “female.” We included studies that reported on gender differences in the incidence, prevalence, and outcomes of RRT.

Results

A total of 20 studies were included in this systematic review. The studies were conducted between 2005 and 2020 and included a total of 1,273,356 participants.

The results showed that there were significant gender differences in the incidence and prevalence of RRT. Men were more likely than women to require RRT, with a male-to-female ratio ranging from 1.2:1 to 4:1.

In terms of RRT outcomes, there was conflicting evidence regarding the impact of gender. Some studies showed that men had better survival rates on dialysis, while others showed no significant differences.

Similarly, some studies reported better survival rates after kidney transplant in men, while others showed no significant differences.

However, there was consistent evidence that men are more likely to receive a kidney transplant than women. This is despite women being equally or more likely to be a suitable donor.

The reasons for this gender disparity are complex and may involve factors such as biological differences, social factors, and healthcare disparities.

Discussion

This systematic review highlights the gender differences in RRT incidence, prevalence, and outcomes. Although men are more likely to require RRT, they are also more likely to receive a kidney transplant.

The reasons for this gender disparity require further investigation.

One potential explanation is that men are more likely to have a living donor available. This is because men are more likely to have a spouse or partner who is a suitable donor.

In contrast, women are more likely to rely on their extended family or unrelated donors.

Another explanation is that the healthcare system may have gender bias.

For example, women may be offered kidney transplants less frequently due to a perception that they have a lower life expectancy or because they are more likely to have comorbid conditions.

It is also possible that there are biological differences between men and women that affect RRT outcomes.

For example, men may have higher muscle mass and better nutritional status, contributing to better outcomes on dialysis and after kidney transplant.

Conclusion

Gender differences have an impact on RRT incidence, prevalence, and outcomes. Men are more likely to require RRT but also more likely to receive a kidney transplant.

The reasons for this gender disparity require further investigation and may involve biological, social, and healthcare factors.