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CKD Progression and Mortality Among Men and Women: A Single Center Study in Taiwan
摘要
BACKGROUND: Sex influences the incidence and prevalence of various renal diseases as well as the rate of chronic kidney disease (CKD) progression. Prior studies have shown that the rate of renal function decline is faster in men. However, the findings vary among different countries. Moreover, these studies were adjusted for limited numbers of confounders. The aim of this study was to examine the impact of sex on end-stage kidney disease (ESKD) risk among patients with moderate to advanced CKD in a single hospital in Taiwan. METHODS: A total of 454 patients with stages 3-5 CKD were prospectively followed for a median of 5.1 years. The primary outcome was ESKD (needing chronic dialysis treatment or preemptive renal transplantation). The secondary outcome was a composite of ESKD or all-cause mortality. RESULTS: The mean age of the patients was 65 ± 13 years, and 65.4% were men. There were 142 ESKD events and 63 deaths. Compared with women, men were associated with a significantly increased risk of ESKD in Cox proportional hazards models adjusted for sex, smoking history, diabetes mellitus, cardiovascular disease, systolic blood pressure, diastolic blood pressure, estimated glomerular filtration rate, urine protein-to-creatinine ratio, use of renin-angiotensin-aldosterone system blocker, hemoglobin, phosphate, total cholesterol, and body mass index (hazard ratio [HR], 3.40; 95% confidence interval [CI], 2.14-5.40). The results were similar when accounting for death as a competing risk (subdistribution HR, 2.86; 95% CI, 1.69-4.83). Futhermore, men also had a significantly higher risk of the composite outcome (HR, 2.75; 95% CI, 1.82-4.17). CONCLUSION: In this CKD cohort, men had a higher risk of ESKD compared with women. Future studies with a larger sample size are needed to validate our observation in the same ethnicity.
延伸閱讀
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