SUN-054 The Impact of Gender on Inpatient Mortality of Hypertensive Patients across CKD Stage 3 to ESRD and Races in the United States

BACKGROUND: Hypertension and chronic kidney disease are two of the most important risk factors for cardiovascular disease, a major cause of death in the US population. The impact of gender in this equation remains unclear, more so, on how it affects the different races. Studies comparing the outcomes and differences in inpatient mortality between males and females with hypertension and CKD are sparse. Our aim was to determine if gender in the US population and menopausal age, affect the inpatient survival rate among hypertensive patients across different CKD stages. METHODS: Data was extracted from the 2005 to 2012 Nationwide Inpatient Sample (NIS). Using propensity score matching, female hypertensive with chronic kidney disease (stage 3, 4, 5 or ESRD) patients were matched with hypertensive males at a 1:1 ratio. We compared inpatient mortality, both crude mortality and mortality per CKD stage, menopausal age, length of stay and total hospital charges between male and females of different Races. Analyses were performed using SAS version 9.3 (SAS Institute, Cary, NC, USA). RESULTS: Among 2,121,750 hospitalized hypertensive patients, 1,092,931 (51.51%) were males and 1,028,819 (48.49%) females. There was 32.09% females with CKD3, 14.69% with CKD4, 3.37% CKD5 and 54.10% with ESRD. On the other side, 32.69% of males have CKD3, 13.22% CKD4, 3.16% CKD5 and 50.93% with ESRD. In-hospital crude mortality was significantly higher for males compared to a matched group of females at CKD stages 3 to 5 (3.09 vs 3.29% p<0.0001 for CKD3; 4.05 vs 4.36% p=0.0004 in CKD4) but was non-significant in ESRD (4.68 vs 4.83% p= 0.45). Factoring menopausal age for each race group, we find women <50y old to have significantly less mortality than men, across all CKD stages and races. Women> 50y have similar mortality rate to men with CKD 3, 4 or 5; while women > 50y with ESRD have a significantly higher mortality than ESRD men of similar race group. CONCLUSION: Inpatient mortality risk of women compared to men through stages of CKD 3 to 6, appears to be reduced in pre-menopausal women, comparable after menopause and increased when on dialysis, irrespective of the race group. Further studies are needed to elucidate the possible links of menopause and the effect of gender with mortality in patients with hypertension and CKD and to assess if this holds true in outpatient settings.