Men are at greater risk for CKD progression, mortality vs women
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Men with chronic kidney disease were more likely to experience disease progression and mortality compared with women, according to results of a 10-year observational study conducted in Sweden.
“There are unexplained sex-specific disparities regarding incidence, prevalence and mortality in different CKD stages and progression to [kidney replacement therapy] KRT initiation,” Oskar Swartling, MD, of the department of medicine, clinical epidemiology division, at the Karolinska Institutet in Stockholm, and colleagues wrote. “The prevalence of early CKD is higher in women compared to men. However, many studies, but not all, suggest a higher risk of KRT in men. Suggested explanations include a faster progression of CKD in men, unequal access to KRT and increased mortality in non-dialysis CKD G5 among women.”
To further investigate differences in CKD progression and mortality between men and women, researchers included 26,279 patients from a nationwide registry.
Overall, 19.6 patients per 100 patient-years experienced disease progression and 10.1 patients per 100 person-years died.
The researchers found that, compared with men, women had a lower risk for CKD progression (sub hazard ratio [SHR] = 0.88), as well as a lower risk for all-cause (SHR = 0.90) and cardiovascular mortality (SHR = 0.83).
“In an analysis of baseline CKD and primary renal diagnoses, we found that, compared to glomerulonephritis, the adjusted risk of CKD progression was higher in patients with diabetic kidney disease, but lower in patients with nephrosclerosis or tubulo-interstitial nephritis,” Swartling and colleagues wrote. “Age, sex, albuminuria and type of primary kidney disease were risk factors of progression.”
According to the researchers, it is important to understand which factors are associated with steeper eGFR decline so that “preventive measures may be taken.”
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