Risk factors of gender for renal progression in patients with early chronic kidney disease

Po Ya Chang, Li Nien Chien, Yuh Feng Lin, Mai Szu Wu, Wen Ta Chiu, Hung Yi Chiou

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Risk factors for chronic kidney disease (CKD), such as hypertension, hyperglycemia, albuminuria, renal structure, and sex hormones, have been reported to have different effects on males and females. Thus, CKD progression may differ depending on sex. In addition to CKD management, treatment at earlier stages can reduce complications and prevent disease progression as well as high medical expenses at late stages. We examined the differences in predictive risk factors for renal progression between male and female patients with early CKD. This case-cohort study recruited patients aged 18 years or older treated in the outpatient departments of 8 hospitals in Taiwan between August 2008 and September 2014. In total, 1530 patients were included in the analysis. Renal progression was defined as ≥25% decline based on baseline estimated glomerular filtration rate. To examine the predictive risk factors for renal progression, we constructed a subset multivariate logistic model with stepwise variable selection by using P < 0.10 for variable retention. The numbers of male and female patients with CKD exhibiting renal progression were 100 (11.64%) and 84 (12.52%), respectively. After adjusting for all the potential confounders, stepwise logistic regression analysis showed that main independent predictive risk factors for the male patients- (C statistic = 0.72) were proteinuria (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.26-3.84), age (OR 1.04; 95% CI 1.02-1.06), anemia (OR 2.75; 95% CI 1.20-6.30), and poor control of blood pressure (OR 1.84; 95% CI 1.05-3.22). However, the main independent predictive factors for the female patients were (C statistic = 0.75) poor glycemic control (OR 2.28; 95% CI 1.22-4.25), poor blood pressure control (OR 1.93; 95% CI 1.06-3.50), and family income (OR 2.51; 95% CI 1.01-6.20). In conclusion, this study demonstrated that proteinuria was the most crucial risk factor for male patients, whereas poor glycemic control was the main risk factor for female patients. Poor blood pressure control was a shared risk factor for male and female patients.

Original languageEnglish
Article number277
JournalMedicine (United States)
Volume95
Issue number30
DOIs
Publication statusPublished - Jul 1 2016
Externally publishedYes

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Chronic Renal Insufficiency
Kidney
Odds Ratio
Confidence Intervals
Blood Pressure
Proteinuria
Disease Progression
Logistic Models
Albuminuria
Hospital Departments
Gonadal Steroid Hormones
Disease Management
Glomerular Filtration Rate
Taiwan
Hyperglycemia
Anemia
Cohort Studies
Outpatients
Regression Analysis
Hypertension

Keywords

  • chronic kidney disease
  • early stage
  • progression
  • sex

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk factors of gender for renal progression in patients with early chronic kidney disease. / Chang, Po Ya; Chien, Li Nien; Lin, Yuh Feng; Wu, Mai Szu; Chiu, Wen Ta; Chiou, Hung Yi.

In: Medicine (United States), Vol. 95, No. 30, 277, 01.07.2016.

Research output: Contribution to journalArticle

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abstract = "Risk factors for chronic kidney disease (CKD), such as hypertension, hyperglycemia, albuminuria, renal structure, and sex hormones, have been reported to have different effects on males and females. Thus, CKD progression may differ depending on sex. In addition to CKD management, treatment at earlier stages can reduce complications and prevent disease progression as well as high medical expenses at late stages. We examined the differences in predictive risk factors for renal progression between male and female patients with early CKD. This case-cohort study recruited patients aged 18 years or older treated in the outpatient departments of 8 hospitals in Taiwan between August 2008 and September 2014. In total, 1530 patients were included in the analysis. Renal progression was defined as ≥25{\%} decline based on baseline estimated glomerular filtration rate. To examine the predictive risk factors for renal progression, we constructed a subset multivariate logistic model with stepwise variable selection by using P < 0.10 for variable retention. The numbers of male and female patients with CKD exhibiting renal progression were 100 (11.64{\%}) and 84 (12.52{\%}), respectively. After adjusting for all the potential confounders, stepwise logistic regression analysis showed that main independent predictive risk factors for the male patients- (C statistic = 0.72) were proteinuria (odds ratio [OR] 2.20; 95{\%} confidence interval [CI] 1.26-3.84), age (OR 1.04; 95{\%} CI 1.02-1.06), anemia (OR 2.75; 95{\%} CI 1.20-6.30), and poor control of blood pressure (OR 1.84; 95{\%} CI 1.05-3.22). However, the main independent predictive factors for the female patients were (C statistic = 0.75) poor glycemic control (OR 2.28; 95{\%} CI 1.22-4.25), poor blood pressure control (OR 1.93; 95{\%} CI 1.06-3.50), and family income (OR 2.51; 95{\%} CI 1.01-6.20). In conclusion, this study demonstrated that proteinuria was the most crucial risk factor for male patients, whereas poor glycemic control was the main risk factor for female patients. Poor blood pressure control was a shared risk factor for male and female patients.",
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