Nephrologists’ Perceptions of Reproductive Care for Women With Kidney Disease

Up to 3% of women of childbearing age have chronic kidney disease, and those who are pregnant face considerable health risks. However, few data are available regarding nephrologists’ perspectives on reproductive care for this population.  

Researchers at the University of Cincinnati College of Medicine in Ohio conducted a survey to identify nephrologists’ beliefs, practices, and perceived barriers to providing reproductive care for women with kidney disease. Results of the survey were reported at the National Kidney Foundation Spring Clinical Meetings 2025.

The 52-item electronic survey was sent to nephrologists across the United States. A total of 497 surveys were disseminated. Of those, 78 were available for evaluation (response rate of 16.3%). Median age of the surveyed nephrologists was 41 to 50 years; 53% were women, 83% practiced solely within an academic setting, and 53.7% had seen more than 15 women of childbearing age with kidney disease in the prior year.

Rates of initiating contraceptive discussions with female patients ranged from never (11%) to always (16%). Many respondents reported being “not at all confident” about managing sexual dysfunction (56.8%), menstrual disorders (42%), breastfeeding (24.7%), and contraception (13.6%). They most often cited the lack of standardized guidelines as a major barrier to providing reproductive care, followed by limited appointment time and lack of interdisciplinary coordination.

Rates of confidence with the issue of reproductive care were significantly higher among nephrologists who saw more than 15 women of childbearing age annually.

“Survey results indicate that a notable proportion of nephrologists in the United States express limited confidence and exhibit inconsistent practices in addressing reproductive health issues of sexual dysfunction and menstrual abnormalities with their female patients, with the absence of standardized guidelines emerging as a major obstacle to counseling. These findings underscore the need for a standardized approach and guidelines at a national level to guide reproductive care among women with kidney disease,” the authors said.

Source: Semaska N, Nolan R, Lee D, Shah S. Contraception, sexual dysfunction, and reproductive health in women with kidney disease: a cross-sectional survey study of nephrologists in the United States. Abstract #G-553. Presented at the National Kidney Foundation Spring Clinical Meetings 2025; April 10-13, 2025; Boston, MA. doi:10.1053/j.ajkd.2025.02.554