Results of previous studies have suggested sex-related disparities in the prognosis of chronic kidney disease (CKD). Akihiko Koshino, MD, and colleagues in Japan conducted a multicenter retrospective study to examine the influence of gender on the prognosis of immunoglobulin A nephropathy (IgA nephropathy). The researchers reported results of the study during a poster session at Kidney Week 2019 in a poster titled Sex-Related Disparities in IgA Nephropathy Progression.
Patients were divided into two groups according to sex. Clinical data at renal biopsy and data on renal outcomes were collected during follow-up. Renal outcomes were defined as 30% decline in estimated glomerular filtration rate (eGFR) from baseline. Cox regression models were used to evaluate the prognostic effects of gender.
The study enrolled 238 patients with IgA nephropathy (male, 124; female, 114). Body mass index (BMI) and high-density lipoprotein (HDL) cholesterol were higher in men than women. Other characteristics, including age, blood pressure, eGFR, and proteinuria were similar between the two groups. Median follow-up was 88 months.
In survival analysis, the hazard ratio (HR) of a 30% decline in eGFR was higher in men than in women (HR, 1.8; 95% confidence interval [CI], 1.1—3.4; P=.003). Gender was also seen as a prognostic factor in multivariable Cox regression analyses with matched BMI and HDL cholesterol (HR, 1.4; 95% CI, 1.1-2.2; P=.02).
Proteinuria and eGFR were common risk factors for 30% decline in eGFR in gender-based survival analysis. Hypertension in men and lower HDL cholesterol in women were gender-specific risk factors of 30% eGFR decline.
Study results suggested “sex-related disparities in progression of IgA nephropathy,” the researchers said.
Source: Koshino A, Wada T, Ogura H, et al. Sex-related disparities in IgA nephropathy progression. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2019 (Abstract TH-PO1015), November 7, 2019, Washington, DC.