ArticleFrontiers in medicine2021
Sex Differences in Kidney Transplantation: Austria and the United States, 1978-2018.
Article in Frontiers in medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Sex and gender as predictors for allograft and patient-relevant outcomes after kidney transplantation.The Cochrane database of systematic reviews · 2024Pooled it
- Ten tips for the first hemodialysis sessions.Clinical kidney journal · 2026Review
- Sex and Intersectional Disparities in Access to Deceased Donor Kidney Transplantation: A 17-Year Population-Based Cohort Study.Nephrology (Carlton, Vic.) · 2026Article
- Enhanced Expression of the Female-Biased Gene Gsta2 in Male Proximal Tubule Cells Improves Renal Resilience to Ischemia-Reperfusion Injury.Journal of the American Society of Nephrology : JASN · 2026Article
- Beyond the resistive index: value of color-coded duplex sonography parameters in kidney transplantation.Frontiers in nephrology · 2026Article
- Sex and Gender Disparities in Kidney Transplantation.Advances in kidney disease and health · 2025Review
- Kidney Transplantation Improves Survival in Lupus Nephritis With End-Stage Kidney Disease.Kidney international reports · 2025Article
- Lower access to kidney transplantation for women in France is not explained by comorbidities and social deprivation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- International comparison and time trends of first kidney transplant recipient characteristics across Europe: an ERA Registry study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Sex differences in the survival benefit of kidney transplantation: a retrospective cohort study using target trial emulation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Chronic kidney disease is more prevalent among women but more men than women are under nephrological care : Analysis from six outpatient clinics in Austria 2019.Wiener klinische Wochenschrift · 2023Article
- Access to treatment in chronic kidney disease, dialysis and transplantation. Is there gender equality?Frontiers in medicine · 2023Review
- Population Characteristics and Clinical Outcomes from the Renal Transplant Outcome Prediction Validation Study (TOPVAS).Journal of clinical medicine · 2022Article
- Sex and gender disparity in kidney transplantation: Historical and future perspectives.Clinical transplantation · 2022Review
- Article
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 6 countries.
Funding
Abstract
backgroundSystematic analyses about sex differences in wait-listing and kidney transplantation after dialysis initiation are scarce. We aimed at identifying sex-specific disparities along the path of kidney disease treatment, comparing two countries with distinctive health care systems, the US and Austria, over time.
methodsWe analyzed subjects who initiated dialysis from 1979-2018, in observational cohort studies from the US and Austria. We used Cox regression to model male-to-female cause-specific hazard ratios (csHRs, 95% confidence intervals) for transitions along the consecutive states dialysis initiation, wait-listing, kidney transplantation and death, adjusted for age and stratified by country and decade of dialysis initiation.
resultsAmong 3,053,206 US and 36,608 Austrian patients starting dialysis, men had higher chances to enter the wait-list, which however decreased over time [male-to-female csHRs for wait-listing, 1978-1987: US 1.94 (1.71, 2.20), AUT 1.61 (1.20, 2.17); 2008-2018: US 1.35 (1.32, 1.38), AUT 1.11 (0.94, 1.32)]. Once wait-listed, the advantage of the men became smaller, but persisted in the US [male-to-female csHR for transplantation after wait-listing, 2008-2018: 1.08 (1.05, 1.11)]. The greatest disparity between men and women occurred in older age groups in both countries [male-to-female csHR for wait-listing after dialysis, adjusted to 75% age quantile, 2008-2018: US 1.83 (1.74, 1.92), AUT 1.48 (1.02, 2.13)]. Male-to-female csHRs for death were close to one, but higher after transplantation than after dialysis.
conclusionsWe found evidence for sex disparities in both countries. Historically, men in the US and Austria had 90%, respectively, 60% higher chances of being wait-listed for kidney transplantation, although these gaps decreased over time. Efforts should be continued to render kidney transplantation equally accessible for both sexes, especially for older women.
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