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A recent study reveals that women undergoing dialysis for kidney failure face different heart health risks compared to men. While women on dialysis experience a higher incidence of heart failure and stroke, they have a lower overall risk of death than their male counterparts, according to researchers led by Dr Silvi Shah, associate professor of nephrology and hypertension at the University of Cincinnati College of Medicine.

The study’s findings suggest a need for gender-specific approaches to heart care for patients on dialysis. "Women have to be treated differently when it comes to their heart health," Dr Shah emphasized in a university news release. “These disparities in cardiovascular health highlight the importance of personalized care for women.”

The study tracked over 508,000 U.S. kidney disease patients who began dialysis between 2005 and 2014. It found that women had a 14 per cent higher risk of developing heart-related complications than men, including a 16 per cent greater likelihood of heart attacks and a 31 per cent higher chance of stroke. Dr Shah noted that this was the first time such significant differences in cardiovascular events between women and men on dialysis have been documented.

One possible explanation for the increased risk in women lies in the role of estrogen, the female hormone that has protective cardiovascular effects. For women on dialysis, estrogen levels typically decline faster, as many enter menopause years earlier than those without kidney issues. “This hormonal shift may make women more vulnerable to cardiovascular problems,” Dr Shah explained.

The study also points to broader disparities in kidney care between men and women. Women often receive less preventive kidney care, which can contribute to the need for dialysis. Once they are on dialysis, they tend to start treatment later, undergo fewer hours of dialysis, and have higher rates of diabetes. Furthermore, women who suffer strokes are less likely to receive adequate post-stroke care compared to men, which can compound their risk of recurring health complications.

Despite these challenges, the study found that women on dialysis had an 11 per cent lower risk of death from heart-related causes and a 4 per cent lower risk of death from any cause than men. The reasons behind this improved survival rate among women remain unclear, leaving researchers with questions. “We don’t know the real reason,” Dr Shah said.

The study, recently published in the Journal of the American Heart Association, calls for more tailored healthcare strategies for women with kidney failure on dialysis to address their unique cardiovascular risks and improve outcomes.

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