Sex Hormone Status in Women With Chronic Kidney Disease: Survey of Nephrologists' and Renal Allied Health Care Providers' Perceptions.
Sex Hormone Status in Women With Chronic Kidney Disease: Survey of Nephrologists' and Renal Allied Health Care Providers' Perceptions.
复制标题
DOI：
10.1177/2054358117734534
复制
发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Ahmed, Sofia B
中科院分区：
文献类型：
--
作者：
Ramesh, Sharanya;James, Matthew T;Ahmed, Sofia B
背景：育龄女性的慢性肾病 (CKD) 伴有月经和生育障碍以及过早绝经。目的：我们试图确定肾脏病专家和相关医疗保健提供者对 CKD 女性性激素状态管理的看法。方法：向来自加拿大、澳大利亚、新西兰和英国的肾脏病学会成员以及加拿大肾脏病护士和技术人员协会发送了一项匿名的互联网调查（2015 年 2 月至 11 月）。我们评估了 CKD 女性对性激素状态的看法和管理。结果：175 名肾脏科医生（21% 回复率）和 121 名专职医疗保健提供者（30%；116 名护士，5 名药剂师）进行了回复。 68% 的肾脏科医生和 46% 的相关服务提供者年龄在 30 至 50 岁之间，38% 的肾脏科医生和 89% 的相关工作人员是女性。 95% 的肾脏科医生同意肾功能影响性激素状态，尽管只有少数肾脏科医生报告经常与患者讨论生育能力（35%，女性与男性肾脏科医生，P = .06）和月经不调（15%，女性与男性肾脏科医生，P = .02）。移植肾病专家报告比非移植肾病专家更频繁地讨论生育能力（53% vs 30%，P = .03）。与专职医疗保健提供者相比，医生更有可能与患者讨论生育问题（33% vs 7.5%，P < .001）和月经不规律（15% vs 9%，P = .04）。 43% 的医生表示不确定绝经后激素治疗对 CKD 女性的作用。结论：肾脏病学家和专职医疗保健提供者认识到 CKD 对女性性激素的影响，但报告称不经常与患者讨论性激素相关问题。我们的国际调查凸显了肾脏病学方面的重要知识差距。
BACKGROUND: Chronic kidney disease (CKD) in reproductive-age women is accompanied by menstrual and fertility disorders and premature menopause.OBJECTIVE: We sought to determine nephrologists' and allied health care providers' perceptions on management of sex hormone status in women with CKD.METHODS: An anonymous, Internet-based survey was sent to nephrology society members from Canada, Australia, New Zealand, and the United Kingdom, and the Canadian Association of Nephrology Nurses and Technologists (February-November 2015). We assessed reported perceptions and management of sex hormone status in women with CKD.RESULTS: One hundred seventy-five nephrologists (21% response rate) and 121 allied health care providers (30%; 116 nurses, 5 pharmacists) responded. Sixty-eight percent of nephrologists and 46% of allied providers were between the ages of 30 and 50 years, and 38% of nephrologists and 89% of allied workers were female. Ninety-five percent of nephrologists agreed that kidney function impacts sex hormone status, although only a minority of nephrologists reported often discussing fertility (35%, female vs male nephrologists, P = .06) and menstrual irregularities with their patients (15%, female vs male nephrologists,P = .02). Transplant nephrologists reported discussing fertility more often than did nontransplant nephrologists (53% vs 30%, P = .03). Physicians were more likely to report discussing fertility (33% vs 7.5%, P < .001) and menstrual irregularities (15% vs 9%, P = .04) with patients than allied health care providers. Forty-three percent of physicians reported uncertainty about the role for postmenopausal hormone therapy in women with CKD.CONCLUSION: Nephrologists and allied health care providers recognize an impact of CKD on sex hormones in women but report not frequently discussing sex hormone-related issues with patients. Our international survey highlights an important knowledge gap in nephrology.