Analysis reveals gender differences in chronic kidney disease identification, monitoring and treatment

New research published in JASN revealed large gender differences in the detection, monitoring and management of chronic kidney disease (CKD) in Sweden. Efforts to ensure equitable care between the sexes may have important implications for reducing the burden of CKD in this country and elsewhere.

Globally, there are gender differences in etiology, prevalence, progression, and outcomes in patients with CKD, which may Explained by biological differences between men and women, but also by differences in the quality of care provided to them. Importantly, the guidelines have clear recommendations on how to screen, diagnose, monitor, and care for individuals at risk for or with established CKD, and these recommendations are not gender-based.

Team led by Juan Jesus Carrero, Pharm, Ph.D. and Oskar Swartling, MD, Ph.D. Students (Karolinska Institutet, Sweden) studied various indicators of CKD care in 227,847 people whose first detection of low levels of renal function in the Stockholm health system between 2009 and 2017 indicated possible CKD.

Researchers found that compared with men with similar characteristics, women received CKD-related diagnostic codes, were Referral to a nephrologist and their renal function are monitored. In addition, women were less likely to receive guideline-recommended medications.

“We expected to find little or no differences in how men and women were managed, as the guidelines did not separate gender Distinction. Instead, we observed large differences in CKD detection efforts and management, suggesting suboptimal care among women. Surprisingly, these differences were observed in high-risk groups and indications, such as those with diabetes , macroalbuminuria, or end-stage chronic kidney disease,” said Dr. Carrero. “This study identifies health care disparities that explain previously reported gender differences in prevalence, progression rates, and outcomes in patients with chronic kidney disease.”

Analysis of time trends over the past decade shows that many measures have improved over time—for example, the rate of certain kidney function tests has increased over the years, However, the detection rate of women with CKD has been lower than that of men.

“We are unable to identify the cause between the underlying under-management and speculate on possible causes, such as in explaining Challenges in serum creatinine (a marker of kidney function and a waste product from the normal wear and tear of the body’s muscles), these women were on average smaller and had lower muscle mass than men,” Swartling said. “There may also be a subconscious bias in healthcare professionals who believe that CKD is less of a problem for women, or that women themselves are more likely to deny their disease. Regardless, our study draws attention to a health care gap that can be corrected. .”