Risk Factor, Age and Sex Differences in Chronic Kidney Disease Prevalence in a Diabetic Cohort: The Pathways Study

• Published in: American journal of nephrology Vol. 36; no. 3; pp. 245 - 251
• Main Authors: Yu, Margaret K., Lyles, Courtney Rees, Bent-Shaw, Luis A., Young, Bessie A.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2012
• Subjects: Age Factors; Aged; Blood Glucose - analysis; Cohort Studies; Cross-Sectional Studies; Diabetes Complications - therapy; Diabetes Mellitus - epidemiology; Female; Glomerular Filtration Rate; Humans; Hypertension - complications; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - therapy; Male; Middle Aged; Original Report: Patient-Oriented, Translational Research; Prevalence; Risk Factors; Sex Factors; Sex difference; Gender difference; Diabetic kidney disease
• ISSN: 0250-8095; 1421-9670; 1421-9670
• DOI: 10.1159/000342210

Background/Aims: Women with diabetes experience a disproportionately greater burden of diabetic kidney disease (DKD) risk factors compared to men; however, sex-specific differences in DKD are not well defined. The effect of age on sex differences in DKD is unknown. Methods: We performed a cross-sectional analysis of the prevalence of DKD (eGFR <60 ml/min/1.73 m 2 or microalbuminuria), advanced DKD (eGFR <30 ml/min/1.73 m 2 ), and common DKD risk factors in the Pathways Study (n = 4,839), a prospective cohort study of diabetic patients from a managed care setting. Subjects were stratified by age <60 and ≥60 years to examine for differences by age. Logistic regression models examined the association between sex and prevalence of DKD and risk factors. Results: Women of all ages had 28% decreased odds of DKD (OR 0.72, 95% CI 0.62–0.83); however, they had a greater prevalence of advanced DKD (OR 1.67, 95% CI 1.05–2.64), dyslipidemia (OR 1.42, 95% CI 1.16–1.74), and obesity (OR 1.87, 95% CI 1.60–2.20) compared to men. Women had similar odds of hypertension and poor glycemic control as men. Women ≥60 years had increased odds of advanced DKD, hypertension, dyslipidemia, and obesity compared to similarly aged men. Women <60 years had increased odds of obesity compared to their male counterparts. Conclusion: Women with diabetes had an increased prevalence of advanced DKD and common DKD risk factors compared to men and these disparities were most prominent amongst the elderly.