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Kidney Week

Abstract: TH-PO1027

Longitudinal Assessment of eGFR Decline by Sex and Ethnicity: A Nationwide Israeli Cohort

Session Information

Category: Women's Health and Kidney Diseases

  • 2200 Women's Health and Kidney Diseases

Authors

  • Cohen-Hagai, Keren, Meir Medical Center, Kefar Sava, Center District, Israel
  • Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States
  • Hornik-Lurie, Tzipi, Meir Medical Center, Kefar Sava, Center District, Israel
  • Karpati, Tomas, Holon Institute of Technology, Holon, Tel Aviv District, Israel
  • Einbinder, Yael, Meir Medical Center, Kefar Sava, Center District, Israel
Background

The importance of sex and ethnicity-related differences in chronic kidney disease (CKD) is increasingly recognized, especially regarding diagnosis, risk stratification, and management. Israeli subpopulations remain underrepresented in comparative CKD research, and their outcomes are often underreported

Methods

In this study, we utilized a large electronic database from Clalit Health Services to investigate patterns of CKD progression in Israeli subpopulations. This retrospective longitudinal analysis accounted for sex differences, ethnic background, and classic CKD risk factors—including hypertension, diabetes, and obesity—using statistical adjustment for potential confounders. The primary outcome was a decline of more than 50% in estimated glomerular filtration rate (eGFR), over a follow-up period of up to 15 years

Results

The initial cohort included 1,855,683 individuals aged ≥25 years. After applying exclusion criteria—missing creatinine data, prior CKD stage 5 or RRT, insufficient health system membership, and non–Israel-born status—a total of 1,297,795 Israel-born individuals were included in the final analysis. Of these, 898,080 were Jewish and 399,715 were Arab. The primary outcome (≥50% decline in eGFR) occurred in 3.9% (n=50,009). Compared to Jewish males (reference), hazard ratios were 1.56 for Arab males, 1.57 for Arab females, and 0.79 for Jewish females.

Conclusion

These differences underscore the role of sex and ethnicity in CKD progression, while also highlighting the influence of additional contributing factors. Recognizing and addressing these disparities can help promote more patient-centered and equitable strategies for CKD prevention and management

Cox proportional hazards regression model
adjusted for age, ethnicity, sex and baseline eGFR. Jewish male -reference group

Digital Object Identifier (DOI)