Abstract: TH-PO881

Sex-Specific Differences in Blood Stream Infection and Hospitalization Rates in Hemodialysis Patients

Session Information

  • Dialysis: Infection
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 610 Dialysis: Infection

Authors

  • Reviriego-Mendoza, Marta, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Rosen, Sophia, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Dugan, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care, Waltham, Massachusetts, United States
Background

It is known that men and women have physiological, hormonal, and genetic differences that can impact treatment regimens and clinical outcomes. Investigations on sex-specific differences in patients undergoing hemodialysis (HD) are limited. We performed a cross-sectional analysis to investigate if there are sex specific differences in systolic blood pressure (SBP) levels, blood stream infection (BSI) rates and hospitalization rates.

Methods

We analyzed data from all Fresenius Medical Care North America HD patients in 2016. Patients were grouped in 17-age categories from 18 years to 95 based on their age at initiation of dialysis. Yearly average SBP was calculated for each patient and averaged for each age-group. Hospitalization rates per patient year (ppy) and rate of admissions ppy were calculated for each age-group. We identified patients who had 1 or more BSIs during 2016 and calculated the percent of patients with at least 1 infection in that particular age group.

Results

Overall, we studied data from 230,091 patients; 43% were female. We used linear and quadratic regressions with an interaction term for Sex to study the sex-specific differences. From our analysis we noted: i) SBP remained stable for women at 139 (+/- 1) mmHg in all age groups, while males showed a steady decline from 143 mmHg to 130 mmHg from the age of 25 to 90 (p<.0001). ii) For both genders, BSIs are most common at a young age (between 25 and 40) and decline later in life. However, women exhibited a significantly higher percentage of BSIs compared to men with 9.2% vs 7.5% at age 25-30 (p<.0001). iii) Hospital admission rates ppy were significantly higher for women when compared to men, peaking at age 25 with nearly a 2 fold higher admission rates than men (3.0 vs 1.7 admissions ppy). Admission rates for women declined with age and equaled those of men by the age of 90 (p<.0001).

Conclusion

Our analysis shows that women, in particular those of a younger age, are at a significantly higher risk of BSIs and hospitalization than men. The characterization of these health disparities between the sexes may aid in identifying patients at risk of poorer outcomes.

Funding

  • Commercial Support