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Kidney Week

Abstract: TH-PO0981

Sex-Related Differences in CKD Monitoring and Cardiovascular Risk Management in Australian Primary Care: A Retrospective Cohort Study

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Wallace, Hannah, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Buizen, Luke, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Badve, Sunil, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Ha, Jeffrey Tsun Kit, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Ketema, Daniel Bekele, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Ronksley, Paul E., University of Calgary, Calgary, Alberta, Canada
  • Sasaki, Takaya, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Harris, Katie, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Henry, Amanda, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Woodward, Mark, The George Institute for Global Health, Sydney, New South Wales, Australia
  • Kotwal, Sradha S., The George Institute for Global Health, Sydney, New South Wales, Australia
  • Jun, Min, The George Institute for Global Health, Sydney, New South Wales, Australia
Background

There has been limited assessment of sex-related differences in chronic kidney disease (CKD) management. We aimed to explore sex-related differences in monitoring and cardiovascular risk management of CKD in primary care.

Methods

We identified adults with CKD who attended a general practice participating in MedicineInsight (2011-2020). Sex differences in monitoring and management were assessed within 18 months of meeting diagnostic CKD criteria. Core monitoring was defined as ≥1 measurement of blood pressure, eGFR, UACR, lipids and, in diabetics, HbA1c. Cardiovascular risk management comprised ACEi/ARB and statin prescriptions, blood pressure and lipid control. Adjusted modified Poisson regression determined the relative risk (RR) of outcomes in females vs. males (overall and within subgroups [age, comorbidities and CKD risk categories]).

Results

Of 140,774 patients with CKD, 51.4% were female. Females were older (mean age: 75.8 vs. 72.7 years) and had less prevalent CVD and diabetes. Females were less likely than males to receive core monitoring (RR [95% CI], 0.96 [0.95-0.98]), ACEi/ARB prescription (0.96 [0.95-0.97]; no difference in statin prescription), blood pressure targets (<140/90mmHg: 0.96 [0.95-0.97]) and LDL <2mmol/L (0.82 [0.80-0.84]). Females with advancing age, co-existing CVD, diabetes or hypertension, and moderately increased and high-risk CKD were less likely to be monitored (Figure 1).

Conclusion

Overall, females with CKD were less likely to receive CKD monitoring and cardiovascular risk management. Findings largely persisted in advancing age, comorbidity and CKD risk categories.

Funding

  • Commercial Support – The Renal Division of The George Institute for Global Health has received sponsorship funding provided by Boehringer Ingelheim and Eli Lilly Alliance and is supported by the University of New South Wales Scientia Program. The design, analysis, interpretation or writing of this work was performed independent of all funding bodies.

Digital Object Identifier (DOI)