TY - JOUR
T1 - Sex disparities in hemodialysis access outcomes
T2 - A systematic review
AU - Silpe, Jeffrey
AU - Koleilat, Issam
AU - Yu, Justin
AU - Kim, Young Hun
AU - Taubenfeld, Ella
AU - Talathi, Sonia
AU - Coluccio, Maria
AU - Wang, Karissa
AU - Woo, Karen
AU - Etkin, Yana
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/12
Y1 - 2023/12
N2 - The goal of this systematic review was to collate and summarize the current literature on hemodialysis access outcomes in females, identify differences between females and men, and provide a foundation for future research. A systematic review of the English-language literature was conducted by searching PubMed and Google Scholar for the following terms: “sex,” “hemodialysis access,” “arteriovenous fistula,” “arteriovenous graft,” and “dialysis catheter.” Reference lists from the resulting articles were also evaluated to ensure that any and all relevant primary sources were identified. Studies were then screened by two independent reviewers for inclusion. Of 967 total studies, 53 ultimately met inclusion criteria. Females have lower maturation rates; have decreased rates of primary, primary-assisted, and secondary patency; require more procedures per capita to achieve maturation and to maintain fistula patency; are more likely to receive dialysis via an arteriovenous graft or central venous catheter; and require a longer time and potentially more assistive invasive interventions to achieve a mature fistula. Our findings emphasize the urgent need for further research to evaluate and address the causes of these disparities. Discussion with patients undergoing hemodialysis should include these findings to improve patient education, expectations, satisfaction, and outcomes.
AB - The goal of this systematic review was to collate and summarize the current literature on hemodialysis access outcomes in females, identify differences between females and men, and provide a foundation for future research. A systematic review of the English-language literature was conducted by searching PubMed and Google Scholar for the following terms: “sex,” “hemodialysis access,” “arteriovenous fistula,” “arteriovenous graft,” and “dialysis catheter.” Reference lists from the resulting articles were also evaluated to ensure that any and all relevant primary sources were identified. Studies were then screened by two independent reviewers for inclusion. Of 967 total studies, 53 ultimately met inclusion criteria. Females have lower maturation rates; have decreased rates of primary, primary-assisted, and secondary patency; require more procedures per capita to achieve maturation and to maintain fistula patency; are more likely to receive dialysis via an arteriovenous graft or central venous catheter; and require a longer time and potentially more assistive invasive interventions to achieve a mature fistula. Our findings emphasize the urgent need for further research to evaluate and address the causes of these disparities. Discussion with patients undergoing hemodialysis should include these findings to improve patient education, expectations, satisfaction, and outcomes.
KW - End-stage renal disease
KW - Health care disparity
KW - Hemodialysis access
KW - Sex
KW - Sex differences
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U2 - 10.1053/j.semvascsurg.2023.10.002
DO - 10.1053/j.semvascsurg.2023.10.002
M3 - Review article
C2 - 38030330
AN - SCOPUS:85176423138
SN - 0895-7967
VL - 36
SP - 560
EP - 570
JO - Seminars in Vascular Surgery
JF - Seminars in Vascular Surgery
IS - 4
ER -