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Kidney Week

Abstract: TH-PO1045

The Impact of Gender on Inpatient Mortality of Hypertensive Latino Patients Across CKD Stage 3 to ESRD in the United States

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Nader, Mark Abi, Kidney Care Consults, Memphis, Tennessee, United States
  • Aguilar Campos, Rodrigo, Georgetown University Hospital, Washington, District of Columbia, United States
  • Hassan, Oussama, Royal London Hospital, Austin, Texas, United States
  • Cervantes, Carmen Elena, Aventura Hospital and Medical Center, Aventura, Florida, United States
  • Correa, Ricardo, University of Arizona, Phoenix, Arizona, United States
  • Sharma, Prabin, Yale University Bridgeport Hospital, Bridgeport, Connecticut, United States
  • Shafique, Rehan, Kidney Care Consults, Memphis, Tennessee, United States
  • Hamze, Omar, Kidney Care Consultants, Memphis, Tennessee, United States
  • Vo, Hieu Q., University of Tennessee, Memphis, Tennessee, United States
  • Gordon, Judit, Medstar Georgeotown University Hospital, Washington, District of Columbia, United States
  • Li, Ping, Medstar Georgeotown University Hospital, Washington, District of Columbia, United States
Background

HTN and CKD are two of the most important risk factors for CVD, a major cause of death in the US population. The impact of gender or menopausal age in this equation remains unclear on how it affects the Hispanic population. Studies comparing the difference in inpatient mortality between male and female with hypertension and CKD are sparse. Our aim was to determine if gender in Latino population affect the inpatient survival rate among hypertensive patients across different CKD stages.

Methods

Data was extracted from the 2005 to 2012 Nationwide Inpatient Sample (NIS). Using propensity score matching, female hypertensive with chronic kidney disease (stage 3, 4, 5 or ESRD) patients were matched with hypertensive males at a 1:1 ratio. We compared inpatient mortality, per CKD stage, length of stay and total hospital charges between male and females. Analyses were performed using SAS version 9.3.

Results

Among 227,923 hospitalized hypertensive patients, 118,132 (51.83%) were males and 109,791 (48.17%) females. There was 18.76% females with CKD3, 10.31% with CKD4, 3.85% with CKD 5 not on dialysis and 67.17% with ESRD. Similarly there was 19.47% men with CKD 3, 9.54% with CKD4, 3.63% with CKD5 not on dialysis and 67.43% with ESRD on dialysis. In-hospital mortality was higher for males compared to females before match, (3.89 vs 3.74 p= 0.05), but non significant after matching the groups (3.85 vs 3.79 p= 0.48). Studying the effect of menopausal age, we find Latino women <50y to have less mortality risk compared to matched group of men irrespective of CKD stage while it is not different when comparing Men and women >50y with CKD stages 3 to 5. Post menopausal women with ESRD have a significantly higher mortality compared to men (5.15% vs 4.24%; p<0.0001). Hospitalized hispanic men had higher hospital charges (63,686 vs 61,667 dollars,p=0.001) even though hispanic women had a significantly longer mean length of stay (6.74 vs 6.70 days,p=0.001).

Conclusion

Mortality in Hispanic women with CKD 3 to 5 compared to men, is reduced when < 50y, comparable after >50y and increased when on dialysis. Further studies are needed to elucidate the possible links of menopause and sex hormones with in-hospital mortality of hypertensive hispanic patients.