Health-related quality of life declines more rapidly in older men than women with CKD
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Although older adult women with chronic kidney disease reported a lower health-related quality of life at baseline, men experienced decline almost twice as fast.
Further, higher serum phosphate, lower hemoglobin and preexisting diabetes correlated with lower physical component summary (PCS) and mental component summary (MCS) scores in men.
“Few studies have investigated the interdependence of health-related quality of life (HRQoL) and sex over time in older patients with advanced CKD,” Nicholas C. Chesnaye, PhD, from the department of medical informatics at the Amsterdam Public Health Research Institute in Amsterdam, and colleagues wrote. They added, “An understanding of sex-specific HRQoL over the course of pre-dialysis CKD and the potential mechanisms underlying any differences may provide insights into a patient’s health and needs and aid sex-specific clinical monitoring and the kidney replacement therapy decision-making process. In this paper, we aim to (1) describe the sex-specific evolution of HRQoL in referred patients with CKD of older age, (2) determine which factors explain the difference in HRQOL between the sexes and (3) explore the sex-specific determinants of HRQoL.”
Researchers evaluated 1,421 patients (485 were women; 936 were men) from the European Quality Study on Treatment in Advanced Chronic Kidney Disease, all of which were at least 65 years old with CKD and were not on dialysis.
Between April 2012 and September 2020, patients completed HRQoL surveys and provided PCS and MCS scores at 3- to 6-month intervals. Using the data, researchers modeled trajectories by sex using linear mixed models.
At baseline, women reported lower mean PCS (42) and MCS (60) scores than men (PCS: 55; MCS: 69), but both scores declined about twice as fast in men during follow-up. After adjusting for covariates such as eGFR decline, the difference was partially reduced.
“By assessing HRQoL through a sex perspective, we identified that high levels of phosphate, low levels of hemoglobin and preexisting diabetes were associated with lower HRQoL in men but to a lesser extent in women, warranting further investigation into whether men could benefit from interventions targeting the intensified treatment of anemia and a reduction in serum phosphate levels,” Chesnaye and colleagues wrote. “Implications for this research also nurture speculations on the sex imbalance with respect to the proportion of individuals requiring kidney replacement therapy.”
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