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Kidney Week

Abstract: SA-PO693

Association of Gender with the Utilization of Peritoneal Dialysis

Session Information

  • Peritoneal Dialysis - II
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Vogel, Savannah, University of Wisconsin - Madison, Madison, Wisconsin, United States
  • Astor, Brad C., University of Wisconsin, Madison, Wisconsin, United States
  • Waheed, Sana, University of Wisconsin, Madison, Wisconsin, United States
Background

Peritoneal dialysis (PD) is underutilized in the United States compared to other countries. We analyzed data from the USRDS and US census to assess the association between gender and initial dialysis modality to determine whether gender might impact PD utilization. We also investigated gender-specific associations of age, race/ethnicity, median household income and employment status on the incidence of PD.

Methods

We estimated the proportion of USRDS patients utilizing PD as their initial modality between 2000-2014, adjusting estimates to the mean value of all covariates (age, race, ethnicity, cause of ESRD, comorbidities, incidence year, income and employment status) and compared these estimates for women and men.

Results

108,022 patients (45% women) initiated PD and 1,375,825 patients (44% women) initiated hemodialysis during this time period. Women were more likely than men (OR: 1.16, 95% CI 1.15-1.18) to utilize PD as their initial dialysis modality. Women were more likely than men to initiate PD for age <67. However, this relationship was reversed for those ≥68 years [Fig. 1]. Other factors influencing the likelihood of being on PD included black race (OR: 0.56), median household income (OR for each $10K higher: 1.03), and being employed (OR: 2.49) [Table 1].

Conclusion

Our results indicate that women in the US were more likely than men to utilize PD as their initial modality, but this association varies with age. This study emphasizes the role gender may play in medical decision making and highlights the need to further investigate the factors that influence patients of each gender to choose PD.

Table 1. Gender, race, income and employment influence the likelihood on being on PD.
 Odds Ratio95%CI
Women/Men1.161.15-1.18
Black/White0.560.55-0.57
Each $10K higher in median household income1.031.02-1.04
Part or full-time employed/unemployed2.492.45-2.53