Abstract
BackgroundSince men with chronic kidney disease (CKD) progress faster than women, an accurate assessment of CKD progression rates should be based on gender differences in age-related decline of glomerular filtration rate (GFR) in healthy individuals.MethodsA Chinese sample population from a stratified, multistage, and clustered CKD screening study was classified into healthy, at-risk, and CKD groups. The gender differences in estimated GFR (eGFR) and age-related eGFR decline were calculated for each group after controlling for blood pressure, fasting glucose levels, serum lipids levels, education level, and smoking status. After referencing to the healthy group, gender-specific multivariate-adjusted rates of decline in eGFR and differences in the rates of decline were calculated for both CKD and at-risk groups.ResultsThe healthy, at-risk, and CKD groups consisted of 4569, 7434, and 1573 people, respectively. In all the 3 groups, the multivariate-adjusted eGFRs in men were lower than the corresponding eGFRs in women. In addition, in the healthy and at-risk groups, the rates of decline in eGFR in men were lower than the corresponding rates of decline in women (healthy group: 0.51 mL·min-1·1.73 m-2·yr-1 vs. 0.74 mL·min-1·1.73 m-2·yr-1 and at-risk group: 0.60 mL·min-1·1.73 m-2·yr-1 vs. 0.73 mL·min-1·1.73 m-2·yr-1). However, in the CKD group, the rates of decline in eGFR in men were similar to those in women (0.96 mL·min-1·1.73 m-2·yr-1 vs. 0.91 mL·min-1·1.73 m-2·yr-1). However, after referencing to the healthy group, the rates of decline in eGFR in men in the at-risk and CKD groups were greater faster than the corresponding rates in women (at-risk group: 0.10 mL·min-1·1.73 m-2·yr-1 vs. -0.03 mL·min-1·1.73 m-2·yr-1 and CKD group: 0.44 mL·min-1·1.73 m-2·yr-1 vs. 0.15 mL·min-1·1.73 m-2·yr-1).ConclusionTo accurately assess gender differences in CKD progression rates, gender differences in age-related decline in GFR should be considered.
Highlights
Since men with chronic kidney disease (CKD) progress faster than women, an accurate assessment of CKD progression rates should be based on gender differences in age-related decline of glomerular filtration rate (GFR) in healthy individuals
Men with chronic kidney disease (CKD) progress to end-stage CKD at a faster rate than women[1,2]. This gender-specific difference cannot be fully explained on the basis of differences in blood pressure, glucose metabolism, or serum cholesterol levels
It is speculated that this difference may be related to gender-specific differences in glomerular structure, hemodynamic condition, activity of local cytokines and hormones, gene
Summary
Since men with chronic kidney disease (CKD) progress faster than women, an accurate assessment of CKD progression rates should be based on gender differences in age-related decline of glomerular filtration rate (GFR) in healthy individuals. Men with chronic kidney disease (CKD) progress to end-stage CKD at a faster rate than women[1,2] This gender-specific difference cannot be fully explained on the basis of differences in blood pressure, glucose metabolism, or serum cholesterol levels. To determine the effect of gender alone on CKD progression, these factors should be adjusted. We used a randomly sampled population from a well organized CKD screening study to determine gender-specific difference in CKD progression rates after adjusting for the normal age-related GFR decline and after controlling for potential confounding variables, such as health status, socioeconomic status, and lifestyle behaviors
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