Sex disparities and adverse cardiovascular and kidney outcomes in patients with chronic kidney disease: results from the KNOW-CKD

Chan Young Jung, Ga Young Heo, Jung Tak Park, Young Su Joo, Hyung Woo Kim, Hyunsun Lim, Tae Ik Chang, Ea Wha Kang, Tae Hyun Yoo, Shin Wook Kang, Joongyub Lee, Soo Wan Kim, Yun Kyu Oh, Ji Yong Jung, Kook Hwan Oh, Curie Ahn, Seung Hyeok Han

Research output: Contribution to journalArticlepeer-review

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. Graphic abstract: [Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)1116-1127
Number of pages12
JournalClinical Research in Cardiology
Volume110
Issue number7
DOIs
Publication statusPublished - 2021 Jul

Bibliographical note

Funding Information:
This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, and 2019E320101).

Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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