4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS
Abstract Background and Aims Male sex is considered a major risk factor for cardiovascular (CV) disease in the general population, but the role of this factor in the high risk for CV disease in the pre-dialysis CKD population is still debated. Methods We tested the relationship between sex and fatal...
Gespeichert in:
| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2023-06, Vol.38 (Supplement_1) |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | Supplement_1 |
| container_start_page | |
| container_title | Nephrology, dialysis, transplantation |
| container_volume | 38 |
| creator | Mallamaci, Francesca Provenzano, Pasquale Fabio Parlongo, Giovanna Leonardis, Daniela Caridi, Graziella Marino, Francesco D'arrigo, Graziella Tripepi, Giovanni Luigi Zoccali, Carmine |
| description | Abstract
Background and Aims
Male sex is considered a major risk factor for cardiovascular (CV) disease in the general population, but the role of this factor in the high risk for CV disease in the pre-dialysis CKD population is still debated.
Methods
We tested the relationship between sex and fatal and non-fatal major CV events (myocardial infarction, heart failure, arrhythmia, angina, stroke, transient ischemic attack, peripheral vascular disease, major arterial or venous thrombotic episodes and sudden death) in a cohort including 759 stage 2-5 CKD consecutively recruited from 22 Nephrology units in southern Italy between October 2005 and September 2008. After the initial assessment, patients were followed up for a median time of 36 months (range 0.3–48 months).
Results
Four hundred fifty-five patients were males (60%). The proportion of smokers was about 4 times higher in males (71.4%) than in females (17.4%). Males and females differed in the prevalence of diabetes (38.5% versus 29.6%) and the frequency of background CV comorbidities (35.6% versus 19.7%, P |
| doi_str_mv | 10.1093/ndt/gfad063c_4124 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1093_ndt_gfad063c_4124</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfad063c_4124</oup_id><sourcerecordid>10.1093/ndt/gfad063c_4124</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1224-a8267a00a0b550eb096c447dd56bdda305b2557ed51a0109fdac9a5fc9ced8d73</originalsourceid><addsrcrecordid>eNqNkMFKxDAYhIMoWFcfwFsewLp_0qRpLkJoYy2Wrmy64i2kSSuKukurB9_eLuvFm6e5fDMwH0KXBK4JyGT5ET6Xz4MLkCbeMkLZEYoISyGmScaPUTQzJAYO8hSdTdMrAEgqRIRu9iw2-gmrpsC5WhfV6lGZfFOrNS4qo5XRuGqwaVWpcUljjvP7Aj-ottJNa87RyeDepv7iNxdoc6vb_C6uV2WVqzr2hFIWu4ymwgE46DiHvgOZesZECDztQnAJ8I5yLvrAiYP5zxCcl44PXvo-ZEEkC0QOu37cTtPYD3Y3vry78dsSsHsBdhZg_wiYO1eHzvZr9w_8B-cLWFo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS</title><source>Free E-Journal (出版社公開部分のみ）</source><source>Alma/SFX Local Collection</source><source>Oxford Journals</source><creator>Mallamaci, Francesca ; Provenzano, Pasquale Fabio ; Parlongo, Giovanna ; Leonardis, Daniela ; Caridi, Graziella ; Marino, Francesco ; D'arrigo, Graziella ; Tripepi, Giovanni Luigi ; Zoccali, Carmine</creator><creatorcontrib>Mallamaci, Francesca ; Provenzano, Pasquale Fabio ; Parlongo, Giovanna ; Leonardis, Daniela ; Caridi, Graziella ; Marino, Francesco ; D'arrigo, Graziella ; Tripepi, Giovanni Luigi ; Zoccali, Carmine</creatorcontrib><description>Abstract
Background and Aims
Male sex is considered a major risk factor for cardiovascular (CV) disease in the general population, but the role of this factor in the high risk for CV disease in the pre-dialysis CKD population is still debated.
Methods
We tested the relationship between sex and fatal and non-fatal major CV events (myocardial infarction, heart failure, arrhythmia, angina, stroke, transient ischemic attack, peripheral vascular disease, major arterial or venous thrombotic episodes and sudden death) in a cohort including 759 stage 2-5 CKD consecutively recruited from 22 Nephrology units in southern Italy between October 2005 and September 2008. After the initial assessment, patients were followed up for a median time of 36 months (range 0.3–48 months).
Results
Four hundred fifty-five patients were males (60%). The proportion of smokers was about 4 times higher in males (71.4%) than in females (17.4%). Males and females differed in the prevalence of diabetes (38.5% versus 29.6%) and the frequency of background CV comorbidities (35.6% versus 19.7%, P<0.001). Waist circumference (100.9±12.4 versus 96±14.1 cm), eGFR (37.5±13.4 versus 33±12.7 ml/min/1.73 m2), 24-hour urinary protein excretion (median: 0.7 g/24h, IQR: 0.2-1.6 g/24h versus 0.5, IQR: 0.2-1.2 g/24 h), and haemoglobin (13.4±1.9 versus 12.0±1.4 g/dL) were higher in males than in females. Serum phosphate (3.6±0.75 versus 3.9±0.75 mg/dL), hs-CRP (median; 2.2 mg/dl, IQR: 1-4.7mg/dl versus 2.8 mg/dl, IQR: 1.2-6.4 mg/dl) and total cholesterol (178.3±42.1 versus 198.8±45.6 mg/dl) were lower in males than in females. During follow-up, 42 patients died, and 118 had fatal and non-fatal CV events. On univariate Cox regression analyses, male gender failed to be associated with all-cause mortality but was strongly related to the incidence rate of fatal and non-fatal major CV events [HR 1.75, 95% CI: 1.18-2.60, P=0.006]. Data adjustment for a series of major potential confounders did not materially affect the strength of this relationship [HR:1.78, 95% CI: 1.03-3.09]. Further analysis testing the effect of age on major CV outcomes by gender showed an effect modification by this risk factor on the same outcome (P=0.037) because the hazard ratio of male versus female CV events increased progressively with ageing (Figure 1).
Figure 1:
Conclusion
The excess risk for CV mortality by the male gender in the general population holds in stage G2-5 CKD patients. Age is a modifier for the excess risk for CV events in CKD patients because the risk excess of the male gender increases linearly across a wide age spectrum in CKD patients.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfad063c_4124</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>Nephrology, dialysis, transplantation, 2023-06, Vol.38 (Supplement_1)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Provenzano, Pasquale Fabio</creatorcontrib><creatorcontrib>Parlongo, Giovanna</creatorcontrib><creatorcontrib>Leonardis, Daniela</creatorcontrib><creatorcontrib>Caridi, Graziella</creatorcontrib><creatorcontrib>Marino, Francesco</creatorcontrib><creatorcontrib>D'arrigo, Graziella</creatorcontrib><creatorcontrib>Tripepi, Giovanni Luigi</creatorcontrib><creatorcontrib>Zoccali, Carmine</creatorcontrib><title>4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS</title><title>Nephrology, dialysis, transplantation</title><description>Abstract
Background and Aims
Male sex is considered a major risk factor for cardiovascular (CV) disease in the general population, but the role of this factor in the high risk for CV disease in the pre-dialysis CKD population is still debated.
Methods
We tested the relationship between sex and fatal and non-fatal major CV events (myocardial infarction, heart failure, arrhythmia, angina, stroke, transient ischemic attack, peripheral vascular disease, major arterial or venous thrombotic episodes and sudden death) in a cohort including 759 stage 2-5 CKD consecutively recruited from 22 Nephrology units in southern Italy between October 2005 and September 2008. After the initial assessment, patients were followed up for a median time of 36 months (range 0.3–48 months).
Results
Four hundred fifty-five patients were males (60%). The proportion of smokers was about 4 times higher in males (71.4%) than in females (17.4%). Males and females differed in the prevalence of diabetes (38.5% versus 29.6%) and the frequency of background CV comorbidities (35.6% versus 19.7%, P<0.001). Waist circumference (100.9±12.4 versus 96±14.1 cm), eGFR (37.5±13.4 versus 33±12.7 ml/min/1.73 m2), 24-hour urinary protein excretion (median: 0.7 g/24h, IQR: 0.2-1.6 g/24h versus 0.5, IQR: 0.2-1.2 g/24 h), and haemoglobin (13.4±1.9 versus 12.0±1.4 g/dL) were higher in males than in females. Serum phosphate (3.6±0.75 versus 3.9±0.75 mg/dL), hs-CRP (median; 2.2 mg/dl, IQR: 1-4.7mg/dl versus 2.8 mg/dl, IQR: 1.2-6.4 mg/dl) and total cholesterol (178.3±42.1 versus 198.8±45.6 mg/dl) were lower in males than in females. During follow-up, 42 patients died, and 118 had fatal and non-fatal CV events. On univariate Cox regression analyses, male gender failed to be associated with all-cause mortality but was strongly related to the incidence rate of fatal and non-fatal major CV events [HR 1.75, 95% CI: 1.18-2.60, P=0.006]. Data adjustment for a series of major potential confounders did not materially affect the strength of this relationship [HR:1.78, 95% CI: 1.03-3.09]. Further analysis testing the effect of age on major CV outcomes by gender showed an effect modification by this risk factor on the same outcome (P=0.037) because the hazard ratio of male versus female CV events increased progressively with ageing (Figure 1).
Figure 1:
Conclusion
The excess risk for CV mortality by the male gender in the general population holds in stage G2-5 CKD patients. Age is a modifier for the excess risk for CV events in CKD patients because the risk excess of the male gender increases linearly across a wide age spectrum in CKD patients.</description><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqNkMFKxDAYhIMoWFcfwFsewLp_0qRpLkJoYy2Wrmy64i2kSSuKukurB9_eLuvFm6e5fDMwH0KXBK4JyGT5ET6Xz4MLkCbeMkLZEYoISyGmScaPUTQzJAYO8hSdTdMrAEgqRIRu9iw2-gmrpsC5WhfV6lGZfFOrNS4qo5XRuGqwaVWpcUljjvP7Aj-ottJNa87RyeDepv7iNxdoc6vb_C6uV2WVqzr2hFIWu4ymwgE46DiHvgOZesZECDztQnAJ8I5yLvrAiYP5zxCcl44PXvo-ZEEkC0QOu37cTtPYD3Y3vry78dsSsHsBdhZg_wiYO1eHzvZr9w_8B-cLWFo</recordid><startdate>20230614</startdate><enddate>20230614</enddate><creator>Mallamaci, Francesca</creator><creator>Provenzano, Pasquale Fabio</creator><creator>Parlongo, Giovanna</creator><creator>Leonardis, Daniela</creator><creator>Caridi, Graziella</creator><creator>Marino, Francesco</creator><creator>D'arrigo, Graziella</creator><creator>Tripepi, Giovanni Luigi</creator><creator>Zoccali, Carmine</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20230614</creationdate><title>4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS</title><author>Mallamaci, Francesca ; Provenzano, Pasquale Fabio ; Parlongo, Giovanna ; Leonardis, Daniela ; Caridi, Graziella ; Marino, Francesco ; D'arrigo, Graziella ; Tripepi, Giovanni Luigi ; Zoccali, Carmine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1224-a8267a00a0b550eb096c447dd56bdda305b2557ed51a0109fdac9a5fc9ced8d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Provenzano, Pasquale Fabio</creatorcontrib><creatorcontrib>Parlongo, Giovanna</creatorcontrib><creatorcontrib>Leonardis, Daniela</creatorcontrib><creatorcontrib>Caridi, Graziella</creatorcontrib><creatorcontrib>Marino, Francesco</creatorcontrib><creatorcontrib>D'arrigo, Graziella</creatorcontrib><creatorcontrib>Tripepi, Giovanni Luigi</creatorcontrib><creatorcontrib>Zoccali, Carmine</creatorcontrib><collection>CrossRef</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mallamaci, Francesca</au><au>Provenzano, Pasquale Fabio</au><au>Parlongo, Giovanna</au><au>Leonardis, Daniela</au><au>Caridi, Graziella</au><au>Marino, Francesco</au><au>D'arrigo, Graziella</au><au>Tripepi, Giovanni Luigi</au><au>Zoccali, Carmine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><date>2023-06-14</date><risdate>2023</risdate><volume>38</volume><issue>Supplement_1</issue><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract
Background and Aims
Male sex is considered a major risk factor for cardiovascular (CV) disease in the general population, but the role of this factor in the high risk for CV disease in the pre-dialysis CKD population is still debated.
Methods
We tested the relationship between sex and fatal and non-fatal major CV events (myocardial infarction, heart failure, arrhythmia, angina, stroke, transient ischemic attack, peripheral vascular disease, major arterial or venous thrombotic episodes and sudden death) in a cohort including 759 stage 2-5 CKD consecutively recruited from 22 Nephrology units in southern Italy between October 2005 and September 2008. After the initial assessment, patients were followed up for a median time of 36 months (range 0.3–48 months).
Results
Four hundred fifty-five patients were males (60%). The proportion of smokers was about 4 times higher in males (71.4%) than in females (17.4%). Males and females differed in the prevalence of diabetes (38.5% versus 29.6%) and the frequency of background CV comorbidities (35.6% versus 19.7%, P<0.001). Waist circumference (100.9±12.4 versus 96±14.1 cm), eGFR (37.5±13.4 versus 33±12.7 ml/min/1.73 m2), 24-hour urinary protein excretion (median: 0.7 g/24h, IQR: 0.2-1.6 g/24h versus 0.5, IQR: 0.2-1.2 g/24 h), and haemoglobin (13.4±1.9 versus 12.0±1.4 g/dL) were higher in males than in females. Serum phosphate (3.6±0.75 versus 3.9±0.75 mg/dL), hs-CRP (median; 2.2 mg/dl, IQR: 1-4.7mg/dl versus 2.8 mg/dl, IQR: 1.2-6.4 mg/dl) and total cholesterol (178.3±42.1 versus 198.8±45.6 mg/dl) were lower in males than in females. During follow-up, 42 patients died, and 118 had fatal and non-fatal CV events. On univariate Cox regression analyses, male gender failed to be associated with all-cause mortality but was strongly related to the incidence rate of fatal and non-fatal major CV events [HR 1.75, 95% CI: 1.18-2.60, P=0.006]. Data adjustment for a series of major potential confounders did not materially affect the strength of this relationship [HR:1.78, 95% CI: 1.03-3.09]. Further analysis testing the effect of age on major CV outcomes by gender showed an effect modification by this risk factor on the same outcome (P=0.037) because the hazard ratio of male versus female CV events increased progressively with ageing (Figure 1).
Figure 1:
Conclusion
The excess risk for CV mortality by the male gender in the general population holds in stage G2-5 CKD patients. Age is a modifier for the excess risk for CV events in CKD patients because the risk excess of the male gender increases linearly across a wide age spectrum in CKD patients.</abstract><pub>Oxford University Press</pub><doi>10.1093/ndt/gfad063c_4124</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-0509 |
| ispartof | Nephrology, dialysis, transplantation, 2023-06, Vol.38 (Supplement_1) |
| issn | 0931-0509 1460-2385 |
| language | eng |
| recordid | cdi_crossref_primary_10_1093_ndt_gfad063c_4124 |
| source | Free E-Journal (出版社公開部分のみ）; Alma/SFX Local Collection; Oxford Journals |
| title | 4124 SEX AND CARDIOVASCULAR DISEASE IN STAGE G2-5 CKD PATIENTS |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T09%3A16%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=4124%20SEX%20AND%20CARDIOVASCULAR%20DISEASE%20IN%20STAGE%20G2-5%20CKD%20PATIENTS&rft.jtitle=Nephrology,%20dialysis,%20transplantation&rft.au=Mallamaci,%20Francesca&rft.date=2023-06-14&rft.volume=38&rft.issue=Supplement_1&rft.issn=0931-0509&rft.eissn=1460-2385&rft_id=info:doi/10.1093/ndt/gfad063c_4124&rft_dat=%3Coup_cross%3E10.1093/ndt/gfad063c_4124%3C/oup_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rft_oup_id=10.1093/ndt/gfad063c_4124&rfr_iscdi=true |