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Abstract: PO0539

Sex-Specific Differences in Clinical Outcomes Among Patients with CKD: Results from CKDopps

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Hecking, Manfred, Medical University of Vienna, Nephrology & Dialysis, Vienna, Austria
  • Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Zee, Jarcy, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Hödlmoser, Sebastian, Medical University of Vienna , Department of Epidemiology, Vienna, Austria
  • Stengel, Benedicte, CESP, Inserm U1018, Kidney and Heart Team, Villejuif, France
  • Reichel, Helmut, Nephrologisches Zentrum Villingen-Schwenningen, Villingen-Schwenningen, Germany
  • Yamagata, Kunihiro, University of Tsukuba, Ibaraki, Japan
  • Sesso, Ricardo, Escola Paulista De Medicina, Unifesp, Sao Paulo, Brazil
  • Port, Friedrich K., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Group or Team Name

  • on behalf of CKDopps and CKD REIN investigators
Background

Women have more chronic kidney disease (CKD) than men, but are under-represented in the dialysis population. We aimed to assess sex-specific differences in clinical outcomes among CKD Outcomes and Practice Patterns Study (CKDopps) participants.

Methods

Using data of 5682 CKDopps stage 3-5 patients from Brazil, Germany and the US, we reported cumulative incidence of pre-dialysis death, dialysis, and transplantation, by sex and CKD stage at CKDopps entry. We used Fine & Gray models to assess the effect of sex on the time to events, stratified by CKD stage. Models were adjusted for age and race, and then for eGFR slope in the first 6 months after enrolment, but not for case mix variables as men and women are biologically different.

Results

There were more men than women at baseline (54 vs 46%). Men were more likely on the transplant waitlist (13 vs 10%) and had higher median eGFR at dialysis initiation (11.2 vs 10.6 mL/min/1.73m2). Over a median follow-up of 1.75 years, the crude cumulative incidence of dialysis was higher in men while that of death was similar (Figure). The age- and race-adjusted hazard ratio (HR) (95% CI) between men vs women was 1.59 (1.40-1.82) for dialysis, 1.24 (1.04-1.49) for death and 1.80 (0.85-3.80) for transplantation. After adjustment for eGFR slope, the HR for dialysis was 1.72 (1.46-2.01), but the HR for the other two outcomes remained similar.

Conclusion

Despite higher CKD prevalence in women, more men received treatment at nephrologist-run clinics in our study. Men had a higher chance of commencing dialysis before death, unexplained by CKD progression. This finding helps interpret the preponderance of men in the dialysis population.