Psychosocial issues in women with renal disease

In this article, we review data on the epidemiology and outcomes of women in the US End-Stage Renal Disease (ESRD) Program. The complexity of the psychosocial milieu of patients is described, and levels of analysis are delineated. The relationships between age, marital status and satisfaction, and perception of quality of life and depressive affect level and diagnosis of depression, and medical outcomes have not been determined in large studies of women with renal disease. We present data from our cross-sectional and longitudinal studies of psychosocial outcomes in a population comprised primarily of black patients with ESRD and review some differences between relationships of parameters in the groups of men and women in the study. Women are more likely to be kidney donors rather than recipients in national programs. Women with ESRD treated with hemodialysis appear to be more immunologically responsive to the psychosocial milieu than men. These differences in access to and utilization of health care and relationships between perceptions and immunochemical mediators may have important ramifications for outcomes in women with chronic renal disease. (C) 2003 by the National Kidney Foundation, Inc.