Gender Disparity in Survival amongst End-Stage Renal Disease Patients on Haemodialysis

Gender inequality in access and outcome of health care utilisation has been a major concern worldwide. We evaluated some demographic and clinical characteristics as well as compared the mortality rate between men and women with end-stage renal disease on haemodialysis (HD), to find out if gender has any influence on mortality.

This was a single centre retrospective study. All adult incident and prevalent haemodialysis patients with end-stage renal disease (ESRD) seen between July 2007 and June 2019 were enrolled in the study. Data collected included age, sex, hepatitis B and C viral status, vascular access at the commencement of haemodialysis, duration on haemodialysis, number of dialysis sessions ever conducted and outcome of haemodialysis. The outcome was stratified as alive, dead, or lost to follow up. The primary outcome measure was all-cause mortality. The IBM SPSS Statistical software version 23 was used to analyse the data. Kaplan Meier survival curve was used to compare all-cause mortality between men and women.

This study included 995 HD patients of whom 704 (70.8%) were males. Mean age was 44.7 + 16.3 years. At the end of the study period, 878 (88.2%) patients died. The mortality rates for men and women did not significantly differ with a cumulative median survival of 17 and 16 days respectively (Log-rank = 0.85, p = 0.358). Hepatitis B seropositivity was significantly associated with increased mortality (Hazard Ratio (HR) = 1.2; 95% CI 1.025 - 1.526).

Despite the perceived poor access to modern healthcare services by women in Northern Nigeria, there is no gender disparity in crude mortality in patients with end-stage renal disease on haemodialysis.