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Abstract: FR-PO905

Gender Differences in CKD Progression: Real-World Data (RWD) Analysis

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Stavas, Joseph, ProKidney, Raleigh, North Carolina, United States
  • Filler, Guido, London Health Sciences Centre, London, Ontario, Canada
  • Irwin, Debra E., Aetion, New York, New York, United States
  • Lovett, Kate, Aetion, New York, New York, United States
  • Shah, Rohan J., Aetion, New York, New York, United States
  • Butler, Emily Lynn, ProKidney, Raleigh, North Carolina, United States
  • Ferris, Maria E., University of North Carolina System, Chapel Hill, North Carolina, United States
Background

Large population-based studies for CKD progression are scant. RWD may better predict population trends for dialysis initiation by gender.

Methods

HealthVerity PrivateSource20 closed claims linked with Veradigm Health Insights EHR and Quest laboratory results data of adults with >364 days of continuous enrollment between 1/1/2017 and 11/30/2021 compared progression of CKD stages ≥3b to dialysis, by gender. Patients were required to have ≥2 eGFR measurements 90-365 days apart and followed until they initiated dialysis or end of available data with the first eGFR as the index date. We excluded pregnancy, AKI, ESKD and dialysis during the baseline period. Covariates included gender, country region, age at index date, Deyo-Chronic Comorbidity Index (CCI) Score, eGFRs, payer types, and comorbidities.

Results

14,172 met the study criteria (Table) with a higher proportion of women patients across all stages (p<0.04). Mean (SD) eGFR test results upon cohort entry were clinically similar for men (34.1±8.0) and women (33.8±8.1). The type of insurance differed between men and women (p<0.05) with men more likely to have commercial insurance and women more likely to have Medicaid with no differences in region. Mean Deyo-CCI scores were significantly (p<0.05) higher for men compared to women and a higher proportion of men had osteodystrophy (2.2% vs 1.6%, p = 0.007) while women were more likely to have anemia (21% vs 19.6%, p<0.05). For CKD stages ≥3b, the proportion of men who initiated dialysis was significantly higher (2.5% vs 1.9%, p<0.05), and the mean time to initiation of dialysis was significantly shorter (510±340 vs 530±356 days, p<0.05) compared to women. These results were primarily driven by patients with stage 4 CKD.

Conclusion

RWD confirm that CKD prevalence was higher among women while progression to dialysis was only mildly faster among men. Insurance classes, comorbidity scores, anemia and osteodystrophy rates between genders were found to be significantly different.

CKD Progression to Dialysis
 OverallStage 3bStage 4Stage 5
Men
n=6,198
Women
n=7,974
Men
n= 4,565
Women
n=5,729
Men
n=1,521
Women
n=2,074
Men
n=112
Women
n=170
Age on index date; median [IQR]70
[61, 78]
71
[63, 79]
70
[62, 78]
72
[63, 79]
68
[60, 78]
71
[62, 80]
63
[56, 72]
66
[58, 76]
Dialysis initiation;
n (%)
152 (2.5%)153* (1.9%)27 (0.6%)23 (0.4%)96 (6.3%)97* (4.7%)29 (25.9%)33 (19.4%)
Days to dialysis; mean (SD)510.0 (340.8)529.7* (356.4)567.4 (337.2)515.4* (417.8)546.0 (328.1)588.4* (356.9)337.3 (342.2)371.9 (257.4)

*p < 0.05

Funding

  • Commercial Support