Women are at unique risk from kidney diseases
This year, as International Women’s Day and World Kidney Day coincide, it is time for Indian women to pay more attention to their kidneysopinion Updated: Mar 07, 2018 14:31 IST
Girls and women, who make up 48% of the Indian population and contribute immensely to their families and society, are at unique risks for kidney diseases. Kidney diseases and the issues related to access to health care have a profound impact on the current and future generations.
Chronic kidney disease (CKD) affects 15-20 % of India’s adult population and is one of the top 20 causes of death worldwide. It impacts not only patients but their families with devastating economic consequences. CKD affects 195 million women worldwide and is the eighth leading cause of death in women, with close to 600,000 deaths each year.
In some studies, the risk of developing CKD has been reported to be higher in women than men. Also, diseases like Lupus Nephropathy (Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE)). Also called lupus, SLE is an autoimmune disease. With lupus, the body’s immune system targets its own body tissues. Lupus nephritis (when lupus involves the kidneys) and Chronic Pyleonephritis (chronic pyelonephritis is characterised by renal inflammation and fibrosis induced by recurrent or persistent renal infection, vesicoureteral reflux, or other causes of urinary tract obstruction) ar
e unique to women.
CKD is also a risk factor for adverse pregnancy and reduced fertility. Women who have CKD face increased risk for themselves and the baby. Pregnancies in women with advanced CKD are more difficult to manage with higher rates of hypertensive disorders and preterm births. There is a need for higher awareness about CKD in pregnancy, early diagnosis of CKD in pregnancy and follow-up checks for women with CKD during and after pregnancy.
Pregnancy may also be a valuable occasion for early diagnosis of CKD, thus allowing planning of therapeutic interventions. Pregnancy-related complications increase the risk of kidney disease. Pre-eclampsia (a syndrome in which a defect in the implantation of the placenta affects normal kidneys and induces hypertension and proteinuria) is one of the three leading causes of maternal mortality. Diseases like pre-eclampsia, septic abortion (infection of the placenta) and post-partum haemorrhage (severe bleeding after giving birth) are the leading causes of acute kidney injury (AKI) in young women, and may herald CKD in survivors.
Kidney transplantation is also unequally spread, mostly due to social, cultural and psychological aspects. In India, the national figures show that 70-80% of the patients are male whereas 70- 80% of the donors are female. However, there has been a change in the last few years and one set of data shows that males constitute 67 % of the patients and 56% of the donors are females.
Improved access to care for women is critical for maintaining the health of families, communities and populations. There is need for creating greater awareness, early diagnosis and regular follow-up of CKD in pregnancy. This year, World Kidney Day and International Women’s Day 2018 are commemorated on the same day, giving us an opportunity to highlight the importance of women’s health and particularly the state of their kidneys.
Sanjeev Gulati is director of nephrology at Fortis Institute of Renal Sciences and Transplant
The views expressed are personal