Abstract: TH-PO1005
Reproductive Health and Contraception in Women with Kidney Diseases: A Qualitative Study of US Nephrologists
Session Information
- Women's Health and Kidney Diseases
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Semaska, Nedas, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
- Nolan, Rachael D., University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
- Shah, Silvi, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
Background
Chronic kidney disease impairs fertility, causes sexual dysfunction, and leads to menstrual irregularities. Despite increased pregnancy risks, contraceptive use remains low among women with CKD. Nephrologists’ perspectives on these issues remain underexplored.
Methods
This qualitative study used semi-structured virtual interviews to explore U.S. nephrologists’ views on contraception and reproductive health in women with CKD. Recruitment concluded at thematic saturation (n=25). Interviews were transcribed and analyzed thematically to identify key themes.
Results
Among the interviewees (n=25), 60% were women, 76% practiced in an academic setting, and the median participant’s age was 40 years, with a median of 7 years of practice since fellowship. We identified the following 4 themes and their respective subthemes [in brackets]: (1) physician discomfort regarding discussion of contraception and reproductive health [reliance on patient initiation, hesitation with counseling, uncertainty about scope of practice]; (2) insufficient training and inadequate guidelines [paucity of formal guidelines, limited exposure, reliance on self-education]; (3) lack of interdisciplinary coordination [the patient as an intermediary, fragmentation of care]; (4) need for holistic and patient-centered care [comprehensive and sustained approach, shared decision-making].
Conclusion
Key barriers to lower contraceptive use and management of reproductive health for women with CKD include provider discomfort due to limited exposure and training, lack of clear guidelines, and fragmented care. Despite these challenges, providers recognize the importance of holistic, patient-centered care. These findings highlight the need for targeted interventions to improve contraceptive counseling, increase appropriate contraceptive use, and support shared decision-making for reproductive health in patients with kidney disease.
Thematic Schema of Relationship Between Barriers and Nephrologists' Experiences
Funding
- Other NIH Support