A new study from the University of Cincinnati College of Medicine shows that U.S. doctors who treat kidney disease need better support and guidelines to talk to patients about reproductive health.
The research focused on patients with chronic kidney disease (CKD) and how well their doctors, known as nephrologists, handle topics like periods, sexual health, pregnancy, and birth control.
The study was based on a survey of 104 nephrologists across the country. They were asked about 52 different topics related to sexual and reproductive health. The results, published in Kidney International Reports, showed that most nephrologists rarely talk to patients about these issues.
Dr. Silvi Shah, the study’s lead author and a kidney specialist at UC Health, said that more than 80% of doctors didn’t feel confident discussing sexual problems with patients. Over 60% weren’t confident discussing menstrual issues.
The study pointed out several key reasons for this gap. One big issue is the lack of national treatment guidelines in the U.S. for reproductive health in kidney patients. Without clear guidance, many doctors don’t know how to handle these topics.
Another reason is limited time during appointments, which makes it hard to bring up more sensitive or complex issues.
“Because of problems in the healthcare system and lack of training, many important topics are being missed. Patients are not getting the help they need,” said Dr. Shah. She added that countries in Europe already have such guidelines in place.
The study also found that not all patients are treated equally. Kidney transplant patients are more likely to be counseled about reproductive health, followed by people on dialysis. Patients who haven’t had a transplant or started dialysis may be missing out.
Nedas Semaska, a third-year medical student and first author of the study, said doctors who treat more patients of reproductive age tend to feel more confident talking about things like breastfeeding, birth control, and medication safety during pregnancy. This suggests that experience helps build confidence in handling these issues.
This study builds on earlier work by the same researchers. In a previous study published in the American Journal of Kidney Diseases, they interviewed doctors and found that nephrologists should take a more active role in helping patients with family planning.
That study also recommended better training during nephrology fellowships and the creation of national guidelines for birth control advice.
“These two studies support each other,” said Semaska. “The earlier one used interviews, and this one used a survey to get numbers and statistics.”
Looking ahead, the researchers say more work is needed to understand why existing guidelines aren’t being used more widely, and how to improve support for nephrologists in the U.S.
If you care about kidney health, please read studies about drug that prevents kidney failure in diabetes, and drinking coffee could help reduce risk of kidney injury.
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