Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study
Females have a higher prevalence of chronic kidney disease (CKD) than males but are less likely to be treated with kidney replacement therapy (KRT). We studied the interaction between sex and the association of cardiometabolic risk factors for the decline in kidney function over time. A population-b...
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| Veröffentlicht in: | American journal of kidney diseases 2024-12, Vol.84 (6), p.731-741.e1 |
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| creator | Sullivan, Michael K. Lees, Jennifer S. Rosales, Brenda M. Cutting, Rachel Wyld, Melanie L. Woodward, Mark Webster, Angela C. Mark, Patrick B. De La Mata, Nicole |
| description | Females have a higher prevalence of chronic kidney disease (CKD) than males but are less likely to be treated with kidney replacement therapy (KRT). We studied the interaction between sex and the association of cardiometabolic risk factors for the decline in kidney function over time.
A population-based cohort study.
1,127,731 adults living in Wales, United Kingdom, within the Secure Anonymised Information Linkage Databank.
Sex and risk factors including age, estimated glomerular filtration rate (eGFR), cardiometabolic conditions, smoking, and socioeconomic deprivation. These risk factors were defined using primary care records.
The yearly declines in eGFR and the risk of incident kidney failure defined as long-term KRT and/or sustained eGFR73 years, whereas cardiometabolic risk factors were more important among males. Older females at baseline were less likely to develop incident kidney failure than older males (P for age |
| doi_str_mv | 10.1053/j.ajkd.2024.05.007 |
| format | Article |
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A population-based cohort study.
1,127,731 adults living in Wales, United Kingdom, within the Secure Anonymised Information Linkage Databank.
Sex and risk factors including age, estimated glomerular filtration rate (eGFR), cardiometabolic conditions, smoking, and socioeconomic deprivation. These risk factors were defined using primary care records.
The yearly declines in eGFR and the risk of incident kidney failure defined as long-term KRT and/or sustained eGFR<15mL/min/1.73m2.
Linear mixed effects models and Cox proportional hazards analysis.
The average decline in eGFR at age≤73 years was equal in males and females. After age 73 years, eGFR decline was faster in males than females, particularly for males with heart failure (males−1.22mL/min/1.73m2 per year [95% CI, −1.25 to−1.20] vs females−0.87mL/min/1.73m2 per year [95% CI, −0.89 to−0.85]) and current smokers (males−1.58mL/min/1.73m2 per year [95% CI, −1.60 to−1.55] vs females−1.27mL/min/1.73m2 per year [95% CI, −1.29 to−1.25]). Socioeconomic deprivation was one of the most impactful risk factors on eGFR decline among females aged>73 years, whereas cardiometabolic risk factors were more important among males. Older females at baseline were less likely to develop incident kidney failure than older males (P for age<0.001).
Study of people who were almost exclusively White and who had blood laboratory test data. Reliance on creatinine-based eGFR. Albuminuria and body mass index data were incomplete.
The eGFR decline was faster in males than in females, especially in the setting of heart failure and smoking. Socioeconomic deprivation was an important risk factor associated with eGFR decline, particularly for females. further work is required to explore less well-recognized risk factors, but these findings may inform clinical management strategies of CKD overall and within sex-specific groups.
Kidney function is known to decline at a faster rate among males than females. This study incorporated blood laboratory test results from the routine care of 1.1 million adults living in the United Kingdom and found that the decline in kidney function associated with risk factors varied by sex. Before and at the age of 73 years, the decline in kidney function was similar between males and females. After age 73, cardiometabolic risk factors were associated with faster decline in kidney function among males than females, specifically heart failure and smoking. Socioeconomic deprivation was also associated with the decline in kidney function for both sexes, but it was a stronger risk factor among females. These findings may inform the management of kidney disease overall and within sex-specific groups.
[Display omitted]</description><identifier>ISSN: 0272-6386</identifier><identifier>ISSN: 1523-6838</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2024.05.007</identifier><identifier>PMID: 39053834</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Cardiometabolic Risk Factors ; Chronic kidney disease ; clinical epidemiology ; Cohort Studies ; estimated glomerular filtration rate ; Female ; Glomerular Filtration Rate - physiology ; Humans ; kidney failure ; Male ; Middle Aged ; renal function decline ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Risk Factors ; sex difference ; Sex Factors ; Wales - epidemiology</subject><ispartof>American journal of kidney diseases, 2024-12, Vol.84 (6), p.731-741.e1</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-bfb9069931cce0e3cffd38649306e67fec00acf569e0b942588f7239978da6db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0272638624008680$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39053834$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sullivan, Michael K.</creatorcontrib><creatorcontrib>Lees, Jennifer S.</creatorcontrib><creatorcontrib>Rosales, Brenda M.</creatorcontrib><creatorcontrib>Cutting, Rachel</creatorcontrib><creatorcontrib>Wyld, Melanie L.</creatorcontrib><creatorcontrib>Woodward, Mark</creatorcontrib><creatorcontrib>Webster, Angela C.</creatorcontrib><creatorcontrib>Mark, Patrick B.</creatorcontrib><creatorcontrib>De La Mata, Nicole</creatorcontrib><title>Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Females have a higher prevalence of chronic kidney disease (CKD) than males but are less likely to be treated with kidney replacement therapy (KRT). We studied the interaction between sex and the association of cardiometabolic risk factors for the decline in kidney function over time.
A population-based cohort study.
1,127,731 adults living in Wales, United Kingdom, within the Secure Anonymised Information Linkage Databank.
Sex and risk factors including age, estimated glomerular filtration rate (eGFR), cardiometabolic conditions, smoking, and socioeconomic deprivation. These risk factors were defined using primary care records.
The yearly declines in eGFR and the risk of incident kidney failure defined as long-term KRT and/or sustained eGFR<15mL/min/1.73m2.
Linear mixed effects models and Cox proportional hazards analysis.
The average decline in eGFR at age≤73 years was equal in males and females. After age 73 years, eGFR decline was faster in males than females, particularly for males with heart failure (males−1.22mL/min/1.73m2 per year [95% CI, −1.25 to−1.20] vs females−0.87mL/min/1.73m2 per year [95% CI, −0.89 to−0.85]) and current smokers (males−1.58mL/min/1.73m2 per year [95% CI, −1.60 to−1.55] vs females−1.27mL/min/1.73m2 per year [95% CI, −1.29 to−1.25]). Socioeconomic deprivation was one of the most impactful risk factors on eGFR decline among females aged>73 years, whereas cardiometabolic risk factors were more important among males. Older females at baseline were less likely to develop incident kidney failure than older males (P for age<0.001).
Study of people who were almost exclusively White and who had blood laboratory test data. Reliance on creatinine-based eGFR. Albuminuria and body mass index data were incomplete.
The eGFR decline was faster in males than in females, especially in the setting of heart failure and smoking. Socioeconomic deprivation was an important risk factor associated with eGFR decline, particularly for females. further work is required to explore less well-recognized risk factors, but these findings may inform clinical management strategies of CKD overall and within sex-specific groups.
Kidney function is known to decline at a faster rate among males than females. This study incorporated blood laboratory test results from the routine care of 1.1 million adults living in the United Kingdom and found that the decline in kidney function associated with risk factors varied by sex. Before and at the age of 73 years, the decline in kidney function was similar between males and females. After age 73, cardiometabolic risk factors were associated with faster decline in kidney function among males than females, specifically heart failure and smoking. Socioeconomic deprivation was also associated with the decline in kidney function for both sexes, but it was a stronger risk factor among females. These findings may inform the management of kidney disease overall and within sex-specific groups.
[Display omitted]</description><subject>Adult</subject><subject>Aged</subject><subject>Cardiometabolic Risk Factors</subject><subject>Chronic kidney disease</subject><subject>clinical epidemiology</subject><subject>Cohort Studies</subject><subject>estimated glomerular filtration rate</subject><subject>Female</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Humans</subject><subject>kidney failure</subject><subject>Male</subject><subject>Middle Aged</subject><subject>renal function decline</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Risk Factors</subject><subject>sex difference</subject><subject>Sex Factors</subject><subject>Wales - epidemiology</subject><issn>0272-6386</issn><issn>1523-6838</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAURS0EotPCD7BAXrJJeIkTx0Zs2mmnIFUqmsLacuwXjaeZeLAdaP8eD1NYdvUW754r3UPIuwrKClr2cVvq7b0ta6ibEtoSoHtBFlVbs4ILJl6SBdRdXXAm-Ak5jXELAJJx_pqcMJl5wZoFebjDB6onS9MG6RpHnZyf4sbt6QWm34gTXepgnd9h0r0fnaFrF-_pSpvkQ_xLXsXkdjqhpderNb1EM7oJP9Fz-s3v52NhcaFj_i_9xodE79JsH9-QV4MeI759umfkx-rq-_JLcXN7_XV5flMY1lap6IdeApeSVcYgIDPDYPOgRjLgyLsBDYA2Q8slQi-buhVi6GomZSes5rZnZ-TDsXcf_M8ZY1I7Fw2Oo57Qz1ExEE3XNQJYjtbHqAk-xoCD2oe8LDyqCtTBuNqqg3F1MK6gVdl4ht4_9c_9Du1_5J_iHPh8DGBe-cthUNE4nAxaF9AkZb17rv8PS_KSXg</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Sullivan, Michael K.</creator><creator>Lees, Jennifer S.</creator><creator>Rosales, Brenda M.</creator><creator>Cutting, Rachel</creator><creator>Wyld, Melanie L.</creator><creator>Woodward, Mark</creator><creator>Webster, Angela C.</creator><creator>Mark, Patrick B.</creator><creator>De La Mata, Nicole</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241201</creationdate><title>Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study</title><author>Sullivan, Michael K. ; Lees, Jennifer S. ; Rosales, Brenda M. ; Cutting, Rachel ; Wyld, Melanie L. ; Woodward, Mark ; Webster, Angela C. ; Mark, Patrick B. ; De La Mata, Nicole</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-bfb9069931cce0e3cffd38649306e67fec00acf569e0b942588f7239978da6db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardiometabolic Risk Factors</topic><topic>Chronic kidney disease</topic><topic>clinical epidemiology</topic><topic>Cohort Studies</topic><topic>estimated glomerular filtration rate</topic><topic>Female</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Humans</topic><topic>kidney failure</topic><topic>Male</topic><topic>Middle Aged</topic><topic>renal function decline</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Risk Factors</topic><topic>sex difference</topic><topic>Sex Factors</topic><topic>Wales - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sullivan, Michael K.</creatorcontrib><creatorcontrib>Lees, Jennifer S.</creatorcontrib><creatorcontrib>Rosales, Brenda M.</creatorcontrib><creatorcontrib>Cutting, Rachel</creatorcontrib><creatorcontrib>Wyld, Melanie L.</creatorcontrib><creatorcontrib>Woodward, Mark</creatorcontrib><creatorcontrib>Webster, Angela C.</creatorcontrib><creatorcontrib>Mark, Patrick B.</creatorcontrib><creatorcontrib>De La Mata, Nicole</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sullivan, Michael K.</au><au>Lees, Jennifer S.</au><au>Rosales, Brenda M.</au><au>Cutting, Rachel</au><au>Wyld, Melanie L.</au><au>Woodward, Mark</au><au>Webster, Angela C.</au><au>Mark, Patrick B.</au><au>De La Mata, Nicole</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>84</volume><issue>6</issue><spage>731</spage><epage>741.e1</epage><pages>731-741.e1</pages><issn>0272-6386</issn><issn>1523-6838</issn><eissn>1523-6838</eissn><abstract>Females have a higher prevalence of chronic kidney disease (CKD) than males but are less likely to be treated with kidney replacement therapy (KRT). We studied the interaction between sex and the association of cardiometabolic risk factors for the decline in kidney function over time.
A population-based cohort study.
1,127,731 adults living in Wales, United Kingdom, within the Secure Anonymised Information Linkage Databank.
Sex and risk factors including age, estimated glomerular filtration rate (eGFR), cardiometabolic conditions, smoking, and socioeconomic deprivation. These risk factors were defined using primary care records.
The yearly declines in eGFR and the risk of incident kidney failure defined as long-term KRT and/or sustained eGFR<15mL/min/1.73m2.
Linear mixed effects models and Cox proportional hazards analysis.
The average decline in eGFR at age≤73 years was equal in males and females. After age 73 years, eGFR decline was faster in males than females, particularly for males with heart failure (males−1.22mL/min/1.73m2 per year [95% CI, −1.25 to−1.20] vs females−0.87mL/min/1.73m2 per year [95% CI, −0.89 to−0.85]) and current smokers (males−1.58mL/min/1.73m2 per year [95% CI, −1.60 to−1.55] vs females−1.27mL/min/1.73m2 per year [95% CI, −1.29 to−1.25]). Socioeconomic deprivation was one of the most impactful risk factors on eGFR decline among females aged>73 years, whereas cardiometabolic risk factors were more important among males. Older females at baseline were less likely to develop incident kidney failure than older males (P for age<0.001).
Study of people who were almost exclusively White and who had blood laboratory test data. Reliance on creatinine-based eGFR. Albuminuria and body mass index data were incomplete.
The eGFR decline was faster in males than in females, especially in the setting of heart failure and smoking. Socioeconomic deprivation was an important risk factor associated with eGFR decline, particularly for females. further work is required to explore less well-recognized risk factors, but these findings may inform clinical management strategies of CKD overall and within sex-specific groups.
Kidney function is known to decline at a faster rate among males than females. This study incorporated blood laboratory test results from the routine care of 1.1 million adults living in the United Kingdom and found that the decline in kidney function associated with risk factors varied by sex. Before and at the age of 73 years, the decline in kidney function was similar between males and females. After age 73, cardiometabolic risk factors were associated with faster decline in kidney function among males than females, specifically heart failure and smoking. Socioeconomic deprivation was also associated with the decline in kidney function for both sexes, but it was a stronger risk factor among females. These findings may inform the management of kidney disease overall and within sex-specific groups.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39053834</pmid><doi>10.1053/j.ajkd.2024.05.007</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2024-12, Vol.84 (6), p.731-741.e1 |
| issn | 0272-6386 1523-6838 1523-6838 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Cardiometabolic Risk Factors Chronic kidney disease clinical epidemiology Cohort Studies estimated glomerular filtration rate Female Glomerular Filtration Rate - physiology Humans kidney failure Male Middle Aged renal function decline Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Risk Factors sex difference Sex Factors Wales - epidemiology |
| title | Sex and the Relationship Between Cardiometabolic Risk Factors and Estimated GFR Decline: A Population-Based Cohort Study |
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