Toralf Melsom1,2, Jon Viljar Norvik3,2, Inger Therese Enoksen2, Vidar Stefansson2, Ulla Dorte Mathisen3, Ole Martin Fuskevåg4, Trond G Jenssen2,5, Marit D Solbu3,2, Bjørn O Eriksen3,2. 1. Section of Nephrology, University Hospital of North Norway, Tromsø, Norway toralf.melsom@unn.no. 2. Metabolic and Renal Research Group, UiT Arctic University of Norway, Tromsø, Norway. 3. Section of Nephrology, University Hospital of North Norway, Tromsø, Norway. 4. Department of Laboratory Medicine, University Hospital of North Norway, Tromsø, Norway. 5. Department of Transplant Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: CKD is more prevalent in women, but more men receive kidney replacement therapy for kidney failure. This apparent contradiction is not well understood. METHODS: We investigated sex differences in the loss of kidney function and whether any sex disparities could be explained by comorbidity or CKD risk factors. In the Renal Iohexol Clearance Survey (RENIS) in northern Europe, we recruited 1837 persons (53% women, aged 50-62 years) representative of the general population and without self-reported diabetes, CKD, or cardiovascular disease. Participants' GFR was measured by plasma iohexol clearance in 2007-2009 (n=1627), 2013-2015 (n=1324), and 2018-2020 (n=1384). At each study visit, healthy persons were defined as having no major chronic diseases or risk factors for CKD. We used generalized additive mixed models to assess age- and sex-specific GFR decline rates. RESULTS: Women had a lower GFR than men at baseline (mean [SD], 90.0 [14.0] versus 98.0 [13.7] ml/min per 1.73 m2; P<0.001). The mean GFR change rate was -0.96 (95% confidence interval [CI], -0.88 to -1.04) ml/min per 1.73 m2 per year in women and -1.20 (95% confidence interval [CI], -1.12 to -1.28) in men. Although the relationship between age and GFR was very close to linear in women, it was curvilinear in men, with steeper GFR slopes at older ages (nonlinear effect; P<0.001). Healthy persons had a slower GFR decline, but health status did not explain the sex difference in the GFR decline. CONCLUSION: Among middle-aged and elderly individuals in the general population, decline in the mean GFR in women was slower than in men, independent of health status.
BACKGROUND: CKD is more prevalent in women, but more men receive kidney replacement therapy for kidney failure. This apparent contradiction is not well understood. METHODS: We investigated sex differences in the loss of kidney function and whether any sex disparities could be explained by comorbidity or CKD risk factors. In the Renal Iohexol Clearance Survey (RENIS) in northern Europe, we recruited 1837 persons (53% women, aged 50-62 years) representative of the general population and without self-reported diabetes, CKD, or cardiovascular disease. Participants' GFR was measured by plasma iohexol clearance in 2007-2009 (n=1627), 2013-2015 (n=1324), and 2018-2020 (n=1384). At each study visit, healthy persons were defined as having no major chronic diseases or risk factors for CKD. We used generalized additive mixed models to assess age- and sex-specific GFR decline rates. RESULTS: Women had a lower GFR than men at baseline (mean [SD], 90.0 [14.0] versus 98.0 [13.7] ml/min per 1.73 m2; P<0.001). The mean GFR change rate was -0.96 (95% confidence interval [CI], -0.88 to -1.04) ml/min per 1.73 m2 per year in women and -1.20 (95% confidence interval [CI], -1.12 to -1.28) in men. Although the relationship between age and GFR was very close to linear in women, it was curvilinear in men, with steeper GFR slopes at older ages (nonlinear effect; P<0.001). Healthy persons had a slower GFR decline, but health status did not explain the sex difference in the GFR decline. CONCLUSION: Among middle-aged and elderly individuals in the general population, decline in the mean GFR in women was slower than in men, independent of health status.
Authors: Jarett D Berry; Alan Dyer; Xuan Cai; Daniel B Garside; Hongyan Ning; Avis Thomas; Philip Greenland; Linda Van Horn; Russell P Tracy; Donald M Lloyd-Jones Journal: N Engl J Med Date: 2012-01-26 Impact factor: 91.245
Authors: Bjørn O Eriksen; Ulla D Mathisen; Toralf Melsom; Ole C Ingebretsen; Trond G Jenssen; Inger Njølstad; Marit D Solbu; Ingrid Toft Journal: Kidney Int Date: 2010-09-15 Impact factor: 10.612
Authors: Marieke H C van Rijn; Marie Metzger; Martin Flamant; Pascal Houillier; Jean-Philippe Haymann; Jan A J G van den Brand; Marc Froissart; Benedicte Stengel Journal: Nephrol Dial Transplant Date: 2020-05-01 Impact factor: 5.992