#4758 IMPACT OF GENDER ON CHRONIC KIDNEY DISEASE IN ELDERLY

Abstract

Abstract Background and Aims Men with chronic kidney disease (CKD) progress to end-stage CKD at a faster rate than women Data for the association of sex with chronic kidney disease (CKD) progression are conflicting, a relationship between the two especially among elderly population needs understanding . Method We conducted a prospective study among all elderly population with CKD attending Nephrology OPD between between Jan 2019-Jan 2022 in Tertiary care hospital, Lucknow and assessed for the stage of CKD and their fall in eGFR ie trajectory of fall in eGFR within a year's time. Results A total of 59 elder men and 34 females (>65 years) of age with estimated glomerular filtration rate (eGFR)<45mL/min/1.73 m2 followed up in renal clinics. They were looked for progression to ESRD and morbidity and mortality over time. The age, basic disease, systolic blood pressure, underlying cardiac status and use of rennin angiotensin blockers were similar between the two groups. Baseline eGFRs were 36.4±7.0 in men and 35.0±6.2 mL/min/1.73 m2 in women (P<0.001), the degree of proteinuria among men was found to be statically significant as compared to women in this cohort. During a median follow-up of 2.9 years, (22.3% men) developed ESRD while 7.2 % died. The adjusted risks for ESKD and mortality were higher in men as compared to the women in this cohort.The decline in eGFR was evident across all stages of CKD among men as compared to women. The slop of decline in eGFR and degree of proteinuria was rapid among men compared to women (−2.9; 95% CI, −2.9 to −1.66 mL/min/1.73 m2 per year) than in women (−1.7; 95% CI, −1.92 to −1.55 mL/min/1.73 m2 per year; P<0.001). Although sex differences in eGFR decline were not different across CKD stages (P=0.3), the difference in slopes between men and women was progressively larger with proteinuria >0.5g/d (P = 0.04) Conclusion Elderly men have a steeper decline in eGFR along with higher proteinuria as compared to women indicating that the decline in the mean GFR in women was slower than in men, independent of health status.