Chan-Young Jung1, Ga Young Heo1, Jung Tak Park1, Young Su Joo1, Hyung Woo Kim1, Hyunsun Lim2, Tae Ik Chang3, Ea Wha Kang3, Tae-Hyun Yoo1, Shin-Wook Kang1, Joongyub Lee4, Soo Wan Kim5, Yun Kyu Oh6, Ji Yong Jung7, Kook-Hwan Oh8, Curie Ahn8, Seung Hyeok Han9. 1. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea. 2. Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea. 3. Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea. 4. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea. 6. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 7. Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon, Republic of Korea. 8. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 9. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea. hansh@yuhs.ac.
Abstract
AIMS: Longitudinal studies of the association between sex and adverse clinical outcomes in patients with chronic kidney disease (CKD) are scarce. We assessed whether major outcomes may differ by sex among CKD patients. METHODS: We analyzed a total of 1780 participants with non-dialysis CKD G1-5 from the KoreaN cohort study for Outcome in patients with Chronic Kidney Disease (KNOW-CKD). The primary outcome was a composite of non-fatal cardiovascular events or all-cause mortality. Secondary outcomes included fatal and non-fatal cardiovascular events, all-cause mortality, and a composite kidney outcome of ≥ 50% decline in estimated glomerular filtration rate from baseline or the onset of end-stage kidney disease. RESULTS: There were 1088 (61%) men and 692 (39%) women in the study cohort. The proportion of smokers was significantly higher in men (24% vs. 3%). During 8430 person-years of follow-up, 201 primary outcome events occurred: 144 (13%) in men and 57 (8%) in women, with corresponding incidence rates of 2.9 and 1.7 per 100 person-years, respectively. In multivariable Cox models, men were associated with a 1.58-fold (95% CI 1.06-2.35) higher risk of composite outcome. Propensity score matching analysis revealed similar findings (HR 1.81; 95% CI 1.14-2.91). Risk of all-cause mortality was significantly higher in men of the matched cohort. However, there was no difference in the risk of CKD progression. In the subgroup with coronary artery calcium (CAC) measurements, men had a higher likelihood of CAC progression. CONCLUSIONS: In Korean CKD patients, men were more likely to experience adverse cardiovascular events and death than women.
AIMS: Longitudinal studies of the association between sex and adverse clinical outcomes in patients with chronic kidney disease (CKD) are scarce. We assessed whether major outcomes may differ by sex among CKD patients. METHODS: We analyzed a total of 1780 participants with non-dialysis CKD G1-5 from the KoreaN cohort study for Outcome in patients with Chronic Kidney Disease (KNOW-CKD). The primary outcome was a composite of non-fatal cardiovascular events or all-cause mortality. Secondary outcomes included fatal and non-fatal cardiovascular events, all-cause mortality, and a composite kidney outcome of ≥ 50% decline in estimated glomerular filtration rate from baseline or the onset of end-stage kidney disease. RESULTS: There were 1088 (61%) men and 692 (39%) women in the study cohort. The proportion of smokers was significantly higher in men (24% vs. 3%). During 8430 person-years of follow-up, 201 primary outcome events occurred: 144 (13%) in men and 57 (8%) in women, with corresponding incidence rates of 2.9 and 1.7 per 100 person-years, respectively. In multivariable Cox models, men were associated with a 1.58-fold (95% CI 1.06-2.35) higher risk of composite outcome. Propensity score matching analysis revealed similar findings (HR 1.81; 95% CI 1.14-2.91). Risk of all-cause mortality was significantly higher in men of the matched cohort. However, there was no difference in the risk of CKD progression. In the subgroup with coronary artery calcium (CAC) measurements, men had a higher likelihood of CAC progression. CONCLUSIONS: In Korean CKD patients, men were more likely to experience adverse cardiovascular events and death than women.
Entities:
Keywords:
Cardiovascular events; Chronic kidney disease; Disparities; Mortality; Sex
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