Sex and gender differences in chronic kidney disease and access to care around the globe

作者：Guillermo García-García, Arpana Iyengar, François Folefack Kaze, Ciara Kierans, César Padilla‐Altamira, Valérie A. Luyckx · 发表于：Seminars in Nephrology · 年份：2022 · DOI：10.1016/j.semnephrol.2022.04.001 · 被引用次数：157 · 研究领域：Dialysis and Renal Disease Management、Global Health Care Issues、Healthcare Systems and Reforms

The difference between sex, the biological construct, and gender, the social construct, may be most evident in settings of vulnerability. Globally, chronic kidney disease is more prevalent among women, but the prevalence of end-stage kidney failure, and especially receipt of kidney replacement therapy, is higher in men. These differences likely reflect a combination of physiological and social/structural risk factors that independently modulate kidney disease and/or its progression. The distribution of the most common risk factors such as hypertension and obesity differ between men and women and may impact disease risk differentially. Social and structural gender-related inequities remain stark across the globe. More women live in poverty, receive less education, and are more dependent on others for health care decision making, but men may have a higher risk of injury, occupational exposures, and less access to screening, prevention, and primary care. In this article, we explore how social determinants of health affect kidney disease risk and access to care differentially across genders, and differently across the globe. We also describe specific challenges experienced by boys and girls with kidney disease, how culture and geography may impact kidney care in places where resources are particularly limited such as sub-Saharan Africa, and give examples of social and structural circumstances that place young men and women at high risk of kidney disease in Mexico and Central Amer...