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Kidney Week

Abstract: TH-PO718

Gender Disparities in the Epidemiology and Outcome of Advanced CKD in Ageing Type 2 Diabetes Mellitus: A Multicenter Nationwide Analysis from a Primary Care Cohort of Thailand

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Rattanasompattikul, Manoch, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand
  • Raksasuk, Sukit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Promkan, Moltira, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
  • Masoodi, Sumana, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
  • Ngerninta, Kanyaphak, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand
  • Rongkiettechakorn, Nuttawut, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand
  • Supokawej, Aungkura, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
Background

Chronic kidney disease (CKD) is a significant burden in elderly patients with type 2 diabetes mellitus (T2DM). The body of knowledge on the approach to elderly patients with CKD is still evolving. The status of senior women with advanced CKD has not been fully explored in our population.

Methods

This study evaluated patients >65 years old with T2DM from the largest National Health Security System (NHS) of Thailand from 2011 to 2014. We aimed to determine female gender with respect to the risk of advanced CKD (stages G4 and G5).

Results

Out of the 13,135 patients, 60% were female, 4.8% had CKD stage G4, and 1.4% had CKD stage G5. The mean age was 74±6 years old. The mean body mass index (BMI) was 23.4±4.2 kg/m2. The prevalence of having advanced CKD by gender was 6.2% and 6.1% in females and males, respectively. The multivariate analysis identified the odds ratio (OR) of the female gender (adjusted OR; 95% confidence interval [CI]; P-value) as an independent risk factor for advanced CKD. Model 1without adjustment (1.02; 0.88–1.18; 0.76). Model 2with adjustments by religion, reimbursements, smoking, body mass index and comorbidity covariates included a history of cancer, depression, thalassemia, gout, dyslipidemia, and use of renin-angiotensin-aldosterone system (RAAS) blockage and statin drugs (1.29; 1.03–1.60; 0.024). Model 3was adjusted based on Model 2and yielded laboratory categories of cholesterol, and %glycosylated hemoglobin (HbA1c) (1.29; 1.03–1.59; 0.029).

Conclusion

Women have unique risks for developing kidney diseases. Epidemiological studies suggest that pre-dialysis CKD is more prevalent in women than in men. The present study found that elderly T2DM women had increased risks associated with advanced CKD. We hope this focus issue will increase awareness and challenge of the renal health of women.

Funding

  • Government Support - Non-U.S.