The Impact of Gender and Marital Status on Therapeutic Outcomes of Maintenance Hemodialysis Patients

Background and Aims: The hemodialysis regimen required to treat end stage renal disease (ESRD) can be extremely strict, requiring individuals to deal with multiple acute and chronic stressors. The aim of this study was to assess relationships between compliance and therapeutic goals with marital status separately by sex in uremic patients receiving hemodialysis in Tehran province.

Methods: In December 2005, an observational study was performed that included the whole HD population (2630 patients; 1505 males and 1125 females) from 56 different units in the province of Tehran, an area encompassing 13.5 million inhabitants.

Results: The mean age of patients in this study was 53.4±16.5 years. They were 1505 men (57.2%) and 1125 women (42.8%). Regarding marital status, it was shown that 1855 (72.5%) were married, 59 (2.3%) were divorced and 329 (12.9%) were widowed. A relationship between marital status and sex was found (80.2% of males were married versus 62.1% of females) (P=0.001). Mean hemoglobin level was not significantly different in two sexes (P=0.15) but was different significantly between married and singles (P=0.002). Even if there was no significant difference in achieving the numbers of K/DOQI guideline targets among different sex and marital status, the control was better in those with family support (P<0.05). The numbers of dialysis sessions and vaccination or preference for transplantation did not differ among the groups. As the marital status has a great impact on therapeutic goals achievements and that 38% of females versus 19.8% of males are single they may need more supervision. Higher rate of illiteracy mandates educational facilities to be appropriate to their capabilities.

Conclusions: The bottom line is that although patients with less support can get dialysis in adequate dose, they need more concentration regarding calcium and phosphorus metabolism and anemia management.