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哥伦比亚肾脏替代治疗和移植中的性别差异。

Gender disparities in kidney replacement therapies and transplantation in Colombia.

机构信息

Department of Transplantation Surgery, Colombiana de Trasplantes, Av Carrera, 30 No. 47 A-74, Bogotá, 111311, Colombia.

Department of Transplantation Nephrology, Colombiana de Trasplantes, Bogotá, Colombia.

出版信息

BMC Nephrol. 2024 Feb 26;25(1):70. doi: 10.1186/s12882-024-03492-3.

DOI:10.1186/s12882-024-03492-3
PMID:38408978
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10897986/
Abstract

BACKGROUND

In chronic kidney disease (CKD), there are historical inequities in multiple stages of the pathway for organ transplantation. Women have been recognized as disadvantaged within this process even after several efforts. Therefore, we aimed to analyze the prevalence and incidence of CKD by gender and their access to Kidney replacement therapy (KRT) in Colombia.

METHODS

A cross-sectional study based on secondary analysis of national information on CKD, hypertension, diabetes, waiting list, deceased, and living donor transplantation between 2015 and 2020.

RESULTS

In Colombia, 4.934.914 patients were diagnosed with hypertension, diabetes, or CKD. 60,64% were female, with a mean age of 63.84 years (SD 14,36). Crude incidence for hypertension (10.85 vs. 7.21 /1000 inhabitants), diabetes mellitus (3.77 vs. 2.98 /1000 inhabitants), and CKD (4 vs. 2 /1000 inhabitants) was higher for females. Crude incidence for KRT was 86.45 cases /100.0000 inhabitants. In 2020, 2978 patients were on the waiting list, 44% female. There were 251 deaths on the waiting list, 38% female. This year, 517 kidney transplants were performed, and only 40% were female.

CONCLUSION

In Colombia, there are proportionally more females with CKD and precursor comorbidities. Nevertheless, there are fewer females on the waiting list and transplanted annually.

摘要

背景

在慢性肾脏病（CKD）中，器官移植途径的多个阶段都存在历史上的不平等现象。尽管已经做出了几次努力，但女性在这个过程中仍然处于不利地位。因此，我们旨在分析哥伦比亚按性别划分的 CKD 患病率和发病率及其接受肾脏替代治疗（KRT）的情况。

方法

这是一项基于 2015 年至 2020 年全国 CKD、高血压、糖尿病、等候名单、死亡和活体供者移植的二次分析的横断面研究。

结果

在哥伦比亚，有 4934914 名患者被诊断患有高血压、糖尿病或 CKD。60.64%为女性，平均年龄为 63.84 岁（标准差为 14.36）。女性的高血压粗发病率（10.85 比 7.21/1000 居民）、糖尿病（3.77 比 2.98/1000 居民）和 CKD（4 比 2/1000 居民）发病率较高。KRT 的粗发病率为 86.45 例/10 万居民。2020 年，有 2978 名患者在等候名单上，其中 44%为女性。等候名单上有 251 人死亡，其中 38%为女性。今年进行了 517 例肾脏移植，只有 40%是女性。

结论

在哥伦比亚，患有 CKD 和前驱合并症的女性比例较高。然而，等候名单上和每年接受移植的女性人数较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d48/10897986/1099a5ab80df/12882_2024_3492_Fig11_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d48/10897986/830042712aef/12882_2024_3492_Fig8_HTML.jpg
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2
Meeting Report: First State of the Art Meeting on Gender Disparity in Kidney Transplantation in the Asia-Pacific.会议报告：亚太地区肾脏移植领域性别差异首次前沿会议
Transplantation. 2021 Sep 1;105(9):1888-1891. doi: 10.1097/TP.0000000000003841.
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Editorial: Disparities in transplantation access and outcomes: mind the gap!
社论：移植机会和结果的差距：弥合差距！
Curr Opin Organ Transplant. 2021 Oct 1;26(5):498-500. doi: 10.1097/MOT.0000000000000919.
4
Disparities in living donation.活体捐献的差异。
Curr Opin Organ Transplant. 2021 Oct 1;26(5):542-546. doi: 10.1097/MOT.0000000000000912.
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Gender disparities in transplantation.移植中的性别差异。
Curr Opin Organ Transplant. 2021 Oct 1;26(5):513-520. doi: 10.1097/MOT.0000000000000909.
6
Equity of access to renal transplantation: a European perspective.平等获得肾移植机会：欧洲视角。
Curr Opin Organ Transplant. 2021 Aug 1;26(4):347-352. doi: 10.1097/MOT.0000000000000895.
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Access to kidney transplantation in Mexico, 2007-2019: a call to end disparities in transplant care.墨西哥 2007-2019 年的肾移植途径：呼吁消除移植护理中的差距。
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Sex disparities in dialysis initiation, access to waitlist, transplantation and transplant outcome in German patients with renal disease-A population based analysis.德国肾脏病患者透析起始、进入候补名单、移植和移植结局的性别差异：一项基于人群的分析。
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