Percent changes in CKD mortality tend to be worse for women, some exceptions exist
Click Here to Manage Email Alerts
Although percent changes in age-standardized chronic kidney disease are worse for women in 66% of countries included in this study, exceptions exist in which men experience a less favorable change.
“Whilst the introduction CKD staging in 2002 has invigorated research, there remains much that is unknown about sex (and gender) differences in CKD epidemiology and outcomes,” Carinna Hockham, DPhil, from the George Institute for Global Health at Imperial College in London, and colleagues wrote. “For instance, it is unknown whether changes in age-standardized CKD mortality rates over time, or lack thereof, have been the same in females and males.”
In an observational epidemiological study, researchers used the Global Burden of Disease (GBD) Study data to determine the extend to which sex differences in CKD mortality vary over time. Investigators for the GBD Study collected data on CKD deaths from vital registration, verbal autopsy and surveillance system data between 1980 and 2017.
Using sex as the exposure, researchers sought to measure CKD-associated mortality rates per 100,000 population.
Researchers compared changes in CKD mortality between sexes globally and for the 50 most populous countries. However, in 2019 only, researchers also compared sex differences in age-standardized and age-specific mortality among countries.
Researchers used Poisson regression models to determine whether the relationship between age and global CKD mortality was affected by sex.
Between 1980 and 2019, there was no change in global age-standardized mortality in either sex, and female mortality remained 30% lower than male mortality. Additionally, 36% of the countries included in the analysis showed increasing CKD mortality rates in both sexes. Similarly, changes in CKD mortality rates were worse for women in 66% of the countries, with the greatest change disparities occurring in Egypt, Thailand and Malaysia.
The greatest overall percentage increase occurred in Mexico, with a smaller change in women (81% vs. 138%). Female mortality ranged from 47% lower and 60% higher than male mortality, in Angola and Egypt, respectively.
“Although female mortality was lower than male mortality in most countries in 2019, three of the five countries with the highest CKD-associated mortality rate had higher female rates (Saudi Arabia, Afghanistan and Egypt). These findings reiterate the need for country-level assessments of sex differences in CKD burden and outcomes to ensure that locally relevant gender-sensitive approaches to CKD prevention and care can be developed,” Hockham and colleagues wrote.
They added, “Furthermore, we have only been able to examine sex differences in mortality for all-stage CKD. However, there is some evidence that sex differences are diminished, or reversed, in patients with more advanced stages, particularly those receiving kidney replacement therapy. Mortality is also only one measure of disease burden; a global assessment of sex differences in disability-adjusted life-years is also warranted to understand whether women live more years with the condition.”
Collapse
Read more about
Click Here to Manage Email Alerts