Ana C. Ricardo
A recently published study shows women have a lower risk of chronic kidney disease progression and death compared to men, while men have a greater likelihood of progressing to ESRD.
Prior studies have been inconsistent in determining whether men or women are at greater risk of CKD, investigators noted in their article.
“The prevalence of CKD is higher in women compared with men, and this difference has been consistent over time (from 13.7% vs. 9.8% in 1988 to 1994 to 15.4% vs. 12.8% in 2011 to 2012),” wrote Ana C. Ricardo, MD, and colleagues who are part of the Chronic Renal Insufficiency Cohort (CRIC) study. “In contrast, the lifetime risk of ESRD has been found to be up to 50% higher in men compared with women across racial/ethnic groups. These findings suggest that women may have slower kidney function decline compared with men or that they are more likely to die before progressing to ESRD.”
In this retrospective review, records of 3,939 adults (1,778 women and 2,161 men) enrolled in the CRIC study were examined. The researchers looked at the differences between sex (women vs. men) and outcomes. They included incident ESRD (defined as undergoing dialysis or a kidney transplant); patients with a 50% eGFR decline from baseline; incident CKD stage 5 (eGFR,15 ml/min per 1.73 m2); eGFR slope and all-cause death. Participants had a mean age of 58 years at the beginning of the study; 42% were non-Hispanic black, and 13% were Hispanic, the researchers reported.
After follow-up (median period of 6.9 years), 844 individuals in the study group 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 authors wrote. “The mean unadjusted eGFR slope was 21.09 ml/min per 1.73 m2 per year in women and 21.43 ml/min per 1.73 m2 per year in men, but this difference was not significant after multivariable adjustment.”
The authors agreed that additional investigation was needed. “Although there were no significant differences in eGFR slopes between women and men after adjusting for demographic and clinical factors, women had lower risk of ESRD and death than men. The role of other biologic and psychosocial factors needs to be further investigated in this population,” they wrote.
Disclosures: The authors report no relevant financial disclosures.