Kidney Week

Abstract: TH-PO1106

The Impact of Gender on Inpatient Mortality of Hypertensive Patients with CKD3 to ESRD in the US

Session Information

• CKD: Clinical, Outcomes, Trials - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Nader, Mark Abi, Kidney Care Consultants, Memphis, Tennessee, United States

Mark Abi Nader,

• Aguilar Campos, Rodrigo, Georgetown University Hospital, Washington, District of Columbia, United States

Rodrigo Aguilar Campos,

• Hassan, Oussama, Royal London Hospital, Austin, Texas, United States

Oussama Hassan,

• Cervantes, Carmen Elena, Aventura Hospital and Medical Center, Aventura, Florida, United States

Carmen Elena Cervantes,

• Correa, Ricardo, University of Arizona, Phoenix, Arizona, United States

Ricardo Correa,

• Sharma, Prabin, Yale University Bridgeport Hospital, Bridgeport, Connecticut, United States

Prabin Sharma,

• Shafique, Rehan, Kidney Care Consultants, Memphis, Tennessee, United States

Rehan Shafique,

• Vo, Hieu Q., university of Tennessee, Memphis, Tennessee, United States

Hieu Q. Vo,

• Hamze, Omar, Kidney Care Consultants, Memphis, Tennessee, United States

Omar Hamze,

• Li, Ping, George Washington University, Washington, District of Columbia, United States

Ping Li,

• Gordon, Judit, Medstar Georgeotown University Hospital, Washington, District of Columbia, United States

Judit Gordon,

Background

HTN and CKD are 2 of the most important risk factors for CVD in the US population.The impact of gender or race in this equation remains unclear. Studies comparing the inpatient mortality between males and females with HTN and CKD are sparse. Our aim was to determine if gender in the US population and menopausal age, affect the inpatient survival rate of hypertensive patients across CKD stages.

Methods

Data was extracted from the 2005-2012 Nationwide Inpatient Sample (NIS). Using propensity score matching, hypertensive female with CKD (stage3-5 + ESRD) patients were matched with hypertensive males at a 1:1 ratio. We compared inpatient mortality per CKD stage, menopausal age and race. Analyses were performed using SAS9.3.

Results

Among 2,121,750 hospitalized hypertensive patients, 51.5% were males and 48.5% females. There was 32.1% females with CKD3, 14.7% with CKD4, 3.4% CKD5 and 54% with ESRD. Similarly, 32.7% of males have CKD3, 13.2% CKD4, 3.2% CKD5 and 50.9% with ESRD. In-hospital crude mortality was significantly higher for males compared to females at CKD stages 3 (3.1 vs 3.3% p<0.0001), CKD4 (4.1 vs 4.4%p=0.0004) and ESRD (5.1 vs 5.2%p=0.0039) but was non-significant in CKD5 not on dialysis (4.7 vs 4.8%p=0.45). Factoring menopausal age for each race group, we find women<50y old to have significantly less mortality than men, across all CKD stages and races. Women> 50y have similar mortality rate to men with CKD 3,4 or 5; while women>50y with ESRD have a significantly higher mortality than ESRD men of similar race group (fig1).

Conclusion

Inpatient mortality risk of women compared to men through stages of CKD 3 to ESRD, appears to be reduced in pre-menopausal women, comparable after menopause and increased when on dialysis, irrespective of the race group. Further studies are needed to elucidate the possible links of menopause and the effect of gender with mortality in patients with hypertension and CKD and to assess if this holds true in outpatient settings.