Women's health issues in a dialysis population

Background: As women receiving hemodialysis are evaluated frequently by the nephrologist, we hypothesized that women's health issues are better addres sed in the dialysis patient than in the general population. Patients and me thods: We surveyed the female patients in our dialysis population. 97% of t he women approached agreed to participate. We found that 55.4% of our cohor t had received routine gynecologic care. 50% of the women had undergone a P apanicolaou (Pap) smear in the last year. Of the women aged 40 - 50, 55% ha d undergone a mammogram in the last 2 years. In women over age 50, 71% rece ived an annual mammogram. Results: We found that 57% of the women were amen orrheic before starting renal replacement therapy while 16% had become amen orrheic after dialysis was started. 27% were still menstruating at the time of the survey. Only 4% of the amenorrheic women interviewed were currently on hormone replacement therapy (HRT) as compared with 20% of women in our general medical clinics. While 67% stated that they would take hormone repl acement if offered, 89% had never been offered HRT. Variables that positive ly correlated with willingness to take HRT were a history of a hysterectomy and more skilled work history. Although nephrologists surveyed at our acad emic facility agreed that amenorrheic women with renal disease benefited fr om HRT, many believed that it is not the role of the nephrologist to prescr ibe it. Conclusion: Despite frequent contacts with medical providers, women 's health issues for patients on dialysis may not receive the same attentio n as women in the general population.