Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease

Women are reported to have a lower incidence of renal replacement therapy, despite a higher prevalence of chronic kidney disease (CKD). To analyze diabetic kidney disease (DKD) progression in men and women. Prospective cohort: = 261, 35% women, new consecutive nephrology DKD referrals. Women smoked...

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Bibliographic Details
Published in:Journal of clinical medicine 2020-05, Vol.9 (6), p.1611
Main Authors: Fernandez-Fernandez, Beatriz, Mahillo, Ignacio, Sanchez-Rodriguez, Jinny, Carriazo, Sol, Sanz, Ana B, Sanchez-Niño, Maria Dolores, Ortiz, Alberto
Format: Article
Language:English
Subjects:
Blood pressure
Cardiovascular disease
Clinical medicine
Diabetes
Diabetic nephropathy
Electrocardiography
Gender differences
Health care access
Heart attacks
Hepatitis
Hypertension
Kidney diseases
Life expectancy
Nephrology
Trends
Variables
Women
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Summary:Women are reported to have a lower incidence of renal replacement therapy, despite a higher prevalence of chronic kidney disease (CKD). To analyze diabetic kidney disease (DKD) progression in men and women. Prospective cohort: = 261, 35% women, new consecutive nephrology DKD referrals. Women smoked less and better complied with the dietary phosphate and sodium restrictions. Despite a less frequent nephrology referral, women had lower baseline albuminuria. Over a 30 ± 10-month follow-up, albuminuria decreased in women and the estimated glomerular filtration rate (eGFR) loss was slower than in men. However, the percentage of rapid progressors was similar in both sexes. The best multivariate model predicting rapid progression in men (area under curve (AUC) = 0.92) and women differed. Albuminuria and fractional excretion of phosphate (FEphosphate) were part of the men multivariable model, but not of women. The AUC for the prediction of rapid progression by albuminuria was higher in men than in women, and the albuminuria cut-off points also differed. In women, there was a higher percentage of rapid progressors who had baseline physiological albuminuria. Female DKD differs from male DKD: albuminuria was milder and better responsive to therapy, the loss of eGFR was slower and the predictors of rapid progression differed from men: albuminuria was a better predictor in men than in women. Lifestyle factors may contribute to the differences.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm9061611