Menstruation and Contraception in Females With CKD: A Global Mixed-Methods Study
Bibliographic record
Abstract
Background: Chronic kidney disease (CKD) in reproductive-aged females is accompanied by menstrual disorders and low contraceptive use. However, most data are limited to the dialysis and transplant populations and in-depth experiences describing this within the scope of CKD have not been studied. Therefore, this mixed-methods study aimed to describe self-assessed menstruation and contraceptive use among females across all stages of CKD. Methods: People aged 18-50 years, with a uterus, and diagnosed with CKD were invited to participate in an online survey followed by an optional telephone interview. The survey was disseminated globally through 112 kidney organizations, patient groups, and social media. Results: Of 152 respondents, 98 satisfied the inclusion criteria [n=20 dialysis (age 35±1 years), n=59 non-dialysis (age 32±1 years), n=19 transplant (age 35±2 years)], representing 3 continents and predominantly self-identifying as white cisgender women. The most common causes of CKD were congenital anomalies of the kidney and urinary tract (30%), acute kidney injury and glomerulonephritis (15% each), and IgA nephropathy (21%) among the dialysis, non-dialysis, and transplant groups, respectively. One participant each in the dialysis and non-dialysis groups experienced primary amenorrhea, though more reported secondary amenorrhea (25% dialysis, 15% non-dialysis, 26% transplant). Of participants with current menses, 86%, 94%, and 100% of the dialysis, non-dialysis, and transplant groups reported heavy menstrual bleeding; however, only 50%, 69%, and 43% were always able to afford period products. Regarding, contraception, 50%, 63%, and 37% of dialysis, non-dialysis, and transplant participants reported no use, though among users, male condoms were notably popular in the dialysis (33%) and non-dialysis (48%) groups. Further, the interviews revealed a need for greater multidisciplinary care in the management of reproductive health in the context of CKD. Conclusions: Abnormal menstruation and period poverty are common, and contraception use is low among females with CKD, highlighting an important gap in the sex-specific care of this population. Funding: Government Support - Non-U.S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".