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Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women
INTRODUCTION: Women are more likely to have chronic kidney disease (CKD), compared with men, yet they are less likely to receive dialysis. Whether this sex disparity, which has predominantly been observed in nephrology-referred or CKD-specific cohorts so far, has a biological root cause remains uncl...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897304/ https://www.ncbi.nlm.nih.gov/pubmed/35257057 http://dx.doi.org/10.1016/j.ekir.2021.12.024 |
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author | Hödlmoser, Sebastian Carrero, Juan Jesus Kurnikowski, Amelie Fu, Edouard L. Swartling, Oskar Winkelmayer, Wolfgang C. Schernhammer, Eva S. Hecking, Manfred |
author_facet | Hödlmoser, Sebastian Carrero, Juan Jesus Kurnikowski, Amelie Fu, Edouard L. Swartling, Oskar Winkelmayer, Wolfgang C. Schernhammer, Eva S. Hecking, Manfred |
author_sort | Hödlmoser, Sebastian |
collection | PubMed |
description | INTRODUCTION: Women are more likely to have chronic kidney disease (CKD), compared with men, yet they are less likely to receive dialysis. Whether this sex disparity, which has predominantly been observed in nephrology-referred or CKD-specific cohorts so far, has a biological root cause remains unclear. METHODS: We extracted general population data from the Stockholm CREAtinine Measurements project (SCREAM) (N = 496,097 participants, 45.5% men, 54.5% women). We used Cox regression to model male-to-female cause-specific hazard ratios (csHRs) for the competing events kidney replacement therapy (KRT, by dialysis or transplantation) and pre-KRT death, adjusted for baseline age, baseline kidney function (assessed via estimated glomerular filtration rate [eGFR] and eGFR slope), and comorbidities. Furthermore, we modeled sex-specific all-cause mortality by eGFR, again adjusted for age, eGFR slope, and comorbidities at baseline. RESULTS: Compared with women, men were significantly more likely to receive KRT (fully adjusted male-to-female csHR for KRT 1.41 [95% CI 1.13–1.76]) but also more likely to experience pre-KRT death (csHR 1.36 [95% CI 1.33–1.38]). Differences between men and women regarding all-cause mortality by eGFR indicated a higher mortality in men at low eGFR values. CONCLUSION: Our data show that sex differences in CKD outcomes persist even after controlling for important comorbidities and kidney function at baseline. While future studies with a wider range of biological factors are warranted, these data suggest that nonbiological factors may be more important in explaining existing sex disparities in CKD progression and therapy. |
format | Online Article Text |
id | pubmed-8897304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-88973042022-03-06 Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women Hödlmoser, Sebastian Carrero, Juan Jesus Kurnikowski, Amelie Fu, Edouard L. Swartling, Oskar Winkelmayer, Wolfgang C. Schernhammer, Eva S. Hecking, Manfred Kidney Int Rep Clinical Research INTRODUCTION: Women are more likely to have chronic kidney disease (CKD), compared with men, yet they are less likely to receive dialysis. Whether this sex disparity, which has predominantly been observed in nephrology-referred or CKD-specific cohorts so far, has a biological root cause remains unclear. METHODS: We extracted general population data from the Stockholm CREAtinine Measurements project (SCREAM) (N = 496,097 participants, 45.5% men, 54.5% women). We used Cox regression to model male-to-female cause-specific hazard ratios (csHRs) for the competing events kidney replacement therapy (KRT, by dialysis or transplantation) and pre-KRT death, adjusted for baseline age, baseline kidney function (assessed via estimated glomerular filtration rate [eGFR] and eGFR slope), and comorbidities. Furthermore, we modeled sex-specific all-cause mortality by eGFR, again adjusted for age, eGFR slope, and comorbidities at baseline. RESULTS: Compared with women, men were significantly more likely to receive KRT (fully adjusted male-to-female csHR for KRT 1.41 [95% CI 1.13–1.76]) but also more likely to experience pre-KRT death (csHR 1.36 [95% CI 1.33–1.38]). Differences between men and women regarding all-cause mortality by eGFR indicated a higher mortality in men at low eGFR values. CONCLUSION: Our data show that sex differences in CKD outcomes persist even after controlling for important comorbidities and kidney function at baseline. While future studies with a wider range of biological factors are warranted, these data suggest that nonbiological factors may be more important in explaining existing sex disparities in CKD progression and therapy. Elsevier 2021-12-27 /pmc/articles/PMC8897304/ /pubmed/35257057 http://dx.doi.org/10.1016/j.ekir.2021.12.024 Text en © 2021 International Society of Nephrology. Published by Elsevier Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Clinical Research Hödlmoser, Sebastian Carrero, Juan Jesus Kurnikowski, Amelie Fu, Edouard L. Swartling, Oskar Winkelmayer, Wolfgang C. Schernhammer, Eva S. Hecking, Manfred Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title | Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title_full | Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title_fullStr | Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title_full_unstemmed | Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title_short | Kidney Function, Kidney Replacement Therapy, and Mortality in Men and Women |
title_sort | kidney function, kidney replacement therapy, and mortality in men and women |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8897304/ https://www.ncbi.nlm.nih.gov/pubmed/35257057 http://dx.doi.org/10.1016/j.ekir.2021.12.024 |
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