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Sex-Related Disparities in CKD Progression

Journal of the American Society of Nephrology, 2019-01, Vol.30 (1), p.137-146 [Peer Reviewed Journal]

Copyright © 2019 by the American Society of Nephrology. ;Copyright © 2019 by the American Society of Nephrology 2019 ;ISSN: 1046-6673 ;EISSN: 1533-3450 ;DOI: 10.1681/asn.2018030296 ;PMID: 30510134

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Title:
Sex-Related Disparities in CKD Progression
Author: Ricardo, Ana C ; Yang, Wei ; Sha, Daohang ; Appel, Lawrence J ; Chen, Jing ; Krousel-Wood, Marie ; Manoharan, Anjella ; Steigerwalt, Susan ; Wright, Jackson ; Rahman, Mahboob ; Rosas, Sylvia E ; Saunders, Milda ; Sharma, Kumar ; Daviglus, Martha L ; Lash, James P
Subjects: Adult ; Aged ; Cause of Death ; Clinical Epidemiology ; Cohort Studies ; Disease Progression ; Female ; Glomerular Filtration Rate ; Health Status Disparities ; Humans ; Kidney Failure, Chronic - diagnosis ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - therapy ; Kidney Function Tests ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Renal Dialysis - methods ; Renal Dialysis - mortality ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Risk Assessment ; Sex Factors ; Survival Analysis ; United States
Is Part Of: Journal of the American Society of Nephrology, 2019-01, Vol.30 (1), p.137-146
Description: In the United States, incidence of ESRD is 1.5 times higher in men than in women, despite men's lower prevalence of CKD. Prior studies, limited by inclusion of small percentages of minorities and other factors, suggested that men have more rapid CKD progression, but this finding has been inconsistent. In our prospective investigation of sex differences in CKD progression, we used data from 3939 adults (1778 women and 2161 men) enrolled in the Chronic Renal Insufficiency Cohort Study, a large, diverse CKD cohort. We evaluated associations between sex (women versus men) and outcomes, specifically incident ESRD (defined as undergoing dialysis or a kidney transplant), 50% eGFR decline from baseline, incident CKD stage 5 (eGFR<15 ml/min per 1.73 m ), eGFR slope, and all-cause death. Participants' mean age was 58 years at study entry; 42% were non-Hispanic black, and 13% were Hispanic. During median follow-up of 6.9 years, 844 individuals developed ESRD, and 853 died. In multivariable regression models, compared with men, women had significantly lower risk of ESRD, 50% eGFR decline, progression to CKD stage 5, and death. The mean unadjusted eGFR slope was -1.09 ml/min per 1.73 m per year in women and -1.43 ml/min per 1.73 m per year in men, but this difference was not significant after multivariable adjustment. In this CKD cohort, women had lower risk of CKD progression and death compared with men. Additional investigation is needed to identify biologic and psychosocial factors underlying these sex-related differences.
Publisher: United States: American Society of Nephrology
Language: English
Identifier: ISSN: 1046-6673
EISSN: 1533-3450
DOI: 10.1681/asn.2018030296
PMID: 30510134
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Alma/SFX Local Collection

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Sex-Related Disparities in CKD Progression

Copyright © 2019 by the American Society of Nephrology. ;Copyright © 2019 by the American Society of Nephrology 2019 ;ISSN: 1046-6673 ;EISSN: 1533-3450 ;DOI: 10.1681/asn.2018030296 ;PMID: 30510134

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