Kidney Week

Abstract: FR-PO868

Sex, Gender, and Quality of Life in Hemodialysis

Session Information

• Diversity and Equity in Kidney Health - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 800 Diversity and Equity in Kidney Health

Authors

• Riehl-Tonn, Victoria J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Victoria J. Riehl-Tonn,

• Dumanski, Sandi M., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Sandi M. Dumanski,

• Elliott, Meghan J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Meghan J. Elliott,

• MacRae, Jennifer M., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Jennifer M. MacRae,

• Pannu, Neesh I., University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada

Neesh I. Pannu,

• Schick-Makaroff, Kara, University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada

Kara Schick-Makaroff,

• Drall, Kelsea, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada

Kelsea Drall,

• Gantar, Taryn, University of Alberta, Edmonton, Alberta, Canada

Taryn Gantar,

• Norris, Colleen M., University of Alberta Faculty of Nursing, Edmonton, Alberta, Canada

Colleen M. Norris,

• Ahmed, Sofia B., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Sofia B. Ahmed,

Background

Women on conventional hemodialysis (HD) have a lower reported quality of life (QoL) compared to men. Incremental HD, which gradually increases dialysis dose over time, is a potential strategy to improve QoL. Despite differences in QoL, current HD prescription remain sex (biology) and gender (sociocultural) blind. We aimed to determine if sex and gender-related measures (gender roles, relations and identity) were associated with QoL when initiating incremental HD (<3 sessions/week) compared to conventional HD (3 sessions/week).

Methods

Patients initiating HD in Alberta, Canada, were invited to enrol (June-December 2021) in this prospective cohort study. Sex assigned at birth was obtained by self-report. Eligibility for incremental HD at initiation is determined by kidney care providers using standardized assessments. The Kidney Disease Quality of Life 36 (KDQOL-36) and the GENESIS-PRAXY Gender Questionnaires were administered at baseline and at 3-months. The physical component score (PCS) and mental component scores (MCS) of the KDQOL-36 determined QoL. The GENESIS-PRAXY creates a composite gender score that is measured on a spectrum, with lower scores consistent with behaviours ascribed to males and high scores consistent behaviours ascribed to females. Non-parametric tests analysed the association between sex and QoL by HD type. Multiple linear regressions explored the association between gender score and QoL by HD type.

Results

All 48 participants identified as cisgender. There were 22 participants on conventional HD (7 female, 15 male) and 26 on incremental (13 female, 13 male) (p=0.11). There was no significant change in MCS (female p= 0.68, male: p=0.41) or PCS (female p= 0.84, male: p=0.61) after 3-months regardless of HD type. Linear regression analysis showed a significant negative association between gender score and PCS (p<0.01, R²=0.54) but not with MCS (p=0.09, R²=0.43).

Conclusion

Sex was not associated with QoL in this cisgender cohort. Behaviours traditionally ascribed to females as indicated by higher gender scores were associated with decreasing QoL with regards to physical health. Understanding sex and gender differences will allow care providers to better address the needs of patients receiving HD.