Females Kidneys & Women’s Health
Dr. Divya Kumar MBBS | DNB - Obstetrics and Gynecology FELLOWSHIP IN ART Consultant ART, Asian-kjivf centre for ART |
contribute to more than 50% of world’s population. The so called “Fairer sex” has always been a victim of gender bias, be it education, basic human rights, medical care or even participation in clinical studies.
As world Kidney day and women’s day coincided in 2018, it gave us an opportunity to reiterate the importance of women’s health, especially their kidney health to the community and the next generation. The International society of nephrology rightly chose the theme Kidneys & Women’s health: Include, Value, Empower !
The burden: CKD affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women. The risk of developing CKD is more likely in women with an average 14% of prevalence. However, the irony is, the number of women on dialysis is much lower than the number of men on dialysis. This is shocking to know that, in live related kidney transplant programs, most of the recipients are males and donors are females.
Pregnancy which is unique to women, may predispose to many complications including kidney problems. In addition some underlying kidney disorders may flare up during pregnancy.
International society of nephrology felt that there is indeed a clear need to address issues of equitable healthcare access for women where it is currently lacking and increase awareness and education to facilitate women’s access to treatment and better health outcomes.
Urinary tract infections in women(uti): 1.2% of all clinic visits by women is due to urinary tract infection. 50% of all women will experience UTI during their lifetime. It is more common in reproductive age group. When not treated adequately, it has a very high recurrence rate causing much agony . Sometimes UTI may herald the onset of blissful marital/sexual activity but on other occasions, this can be a result of Spermicidal use, habitual and post- coitial delayed urination. Douching and wearing occlusive underwear, wiping from behind forward after defecation or using unhygienic water jets in western seats instead of health faucets, may increase the chance of catching UTI. Adequate hydration ( 2- 3 litres/ day) is a simple preventive measure to stay away from UTI. While simple UTI can
UTI and Pregnancy UTI during pregnancy is managed similarly as in non pregnant state with precaution of using antibiotics which are safe for mother and fetus. Sometimes urine routine examination shows infection but the patient is asymptomatic (asymptomatic bactriurea). This otherwise does not require treatment in non-pregnant state but must be treated aggressively with antibiotics in pregnancy as it is associated with an increased risk of premature delivery, IUGR, and perinatal mortality
Pregnancy and Acute kidney injury (AKI)
Pregnant ladies are also prone to develop acute kidney failure/ injury ( AKI). Though good antenatal care has brought down its incidence in developed countries(< 1 in 20,000 pregnancies), the incidence remains high in developing world (1 in 2000 to 5000 pregnancies).
Common cause in early pregnancy are septic abortion ( Quacks and dais ) and excessive vomiting. Most cases occur between gestational week 35 and after delivery. Common causes being Preeclampsia/eclampsia - (15%) ,Post Partum Haemorrhage ( 26%), placental abruption renal impairment, have a lower chance of having a live baby and a greater risk for maternal complications. Hemodialysis, if required should be done under close supervision by an experienced nephrologist. Various women have become pregnant after getting kidney transplant. But ideally a female should donate her kidney only after completing her family.
Pregnancy further adds to the burden
With good preconception, antenatal and postnatal care most of the disorder can be either prevented or managed with no long term serious consequences. Early detection and timely intervention can not only prevent kidney diseases, but also limit the complication and sometimes even save a kidney.
Women are at a greater risk to develop kidney disease in their lifetime but their access to dialysis, transplant and other health care is extremely poor due to bias towards treating males.
This is high time when society should think beyond its male chauvinistic mind set and give women equal access to health and kidney care.