Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease

被引:21
作者
Fernandez-Fernandez, Beatriz [1 ,2 ,3 ]
Mahillo, Ignacio [1 ,2 ]
Sanchez-Rodriguez, Jinny [1 ,2 ,3 ]
Carriazo, Sol [1 ,2 ,3 ]
Sanz, Ana B. [1 ,2 ,3 ]
Sanchez-Nino, Maria Dolores [1 ,2 ,3 ]
Ortiz, Alberto [1 ,2 ,3 ]
机构
[1] Univ Autonoma Madrid, IIS Fdn Jimenez Diaz, Madrid 28040, Spain
[2] Fdn Renal Inigo Alvarez Toledo IRSIN, Madrid 28040, Spain
[3] REDINREN, Madrid 28040, Spain
关键词
diabetic kidney disease; diabetic nephropathy; gender; outcomes; albuminuria; glomerular filtration rate; mortality; METHYLENETETRAHYDROFOLATE REDUCTASE GENE; FOLIC-ACID; NEPHROPATHY; THERAPY; POLYMORPHISM; PHOSPHATE; MODERATE; HEALTH; ADULTS; WOMEN;
D O I
10.3390/jcm9061611
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Women are reported to have a lower incidence of renal replacement therapy, despite a higher prevalence of chronic kidney disease (CKD). Aim: To analyze diabetic kidney disease (DKD) progression in men and women. Methods: Prospective cohort:n= 261, 35% women, new consecutive nephrology DKD referrals. Results: Women smoked less and better complied with the dietary phosphate and sodium restrictions. Despite a less frequent nephrology referral, women had lower baseline albuminuria. Over a 30 +/- 10-month follow-up, albuminuria decreased in women and the estimated glomerular filtration rate (eGFR) loss was slower than in men. However, the percentage of rapid progressors was similar in both sexes. The best multivariate model predicting rapid progression in men (area under curve (AUC) = 0.92) and women differed. Albuminuria and fractional excretion of phosphate (FEphosphate) were part of the men multivariable model, but not of women. The AUC for the prediction of rapid progression by albuminuria was higher in men than in women, and the albuminuria cut-off points also differed. In women, there was a higher percentage of rapid progressors who had baseline physiological albuminuria. Conclusions: Female DKD differs from male DKD: albuminuria was milder and better responsive to therapy, the loss of eGFR was slower and the predictors of rapid progression differed from men: albuminuria was a better predictor in men than in women. Lifestyle factors may contribute to the differences.
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页数:13
相关论文
共 37 条
[1]   Sex Differences in Kidney Replacement Therapy Initiation and Maintenance [J].
Antlanger, Marlies ;
Noordzij, Marlies ;
van de Luijtgaarden, Moniek ;
Carrero, Juan Jesus ;
Palsson, Runolfur ;
Finne, Patrik ;
Hemmelder, Marc H. ;
Areste-Fosalba, Nuria ;
Reisaeter, Anna Varberg ;
Cases, Aleix ;
Traynor, Jamie P. ;
Kramar, Reinhard ;
Massy, Ziad ;
Jager, Kitty J. ;
Hecking, Manfred ;
Zoccali, C. ;
Ambuhl, P. ;
Arici, M. ;
De Meester, J. ;
Evans, M. ;
Harambat, J. ;
Mercadal, L. ;
Nordio, M. ;
Sorensen, S. S. ;
Vidal, E. ;
Kramer, A. ;
Stel, V. S. .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2019, 14 (11) :1616-1625
[2]   Increased Microalbuminuria Risk in Male Cigarette Smokers: Results from the "Olivetti Heart Study" after 8 Years Follow-Up [J].
Barbato, Antonio ;
D'Elia, Lanfranco ;
Perna, Ludovica ;
Molisso, Anna ;
Iacone, Roberto ;
Strazzullo, Pasquale ;
Galletti, Ferruccio .
KIDNEY & BLOOD PRESSURE RESEARCH, 2019, 44 (01) :33-42
[3]   The renin-angiotensin-aldosterone system blockade in patients with advanced diabetic kidney disease [J].
Bermejo, Sheila ;
Garcia, Carles Oriol ;
Rodriguez, Eva ;
Barrios, Clara ;
Otero, Sol ;
Mojal, Sergi ;
Pascual, Julio ;
Soler, Maria Jose .
NEFROLOGIA, 2018, 38 (02) :197-206
[4]   Sex and gender disparities in the epidemiology and outcomes of chronic kidney disease [J].
Carrero, Juan Jesus ;
Hecking, Manfred ;
Chesnaye, Nicholas C. ;
Jager, Kitty J. .
NATURE REVIEWS NEPHROLOGY, 2018, 14 (03) :151-164
[5]   Gender differences in homocysteine concentrations, a population-based cross-sectional study [J].
Cohen, E. ;
Margalit, I. ;
Shochat, T. ;
Goldberg, E. ;
Krause, I. .
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2019, 29 (01) :9-14
[6]  
de Seigneux S, 2017, SWISS MED WKLY, V147
[7]   Proteinuria Increases Plasma Phosphate by Altering Its Tubular Handling [J].
de Seigneux, Sophie ;
Courbebaisse, Marie ;
Rutkowski, Joseph M. ;
Wilhelm-Bals, Alexandra ;
Metzger, Marie ;
Khodo, Stellor Nlandu ;
Hasler, Udo ;
Chehade, Hassib ;
Dizin, Eva ;
Daryadel, Arezoo ;
Stengel, Benedicte ;
Girardin, E. ;
Prie, Dominique ;
Wagner, Carsten A. ;
Scherer, Philipp E. ;
Martin, Pierre-Yves ;
Houillier, Pascal ;
Feraille, Eric .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2015, 26 (07) :1608-1618
[8]   PCSK9 in diabetic kidney disease [J].
Elewa, Usama ;
Fernandez-Fernandez, Beatriz ;
Mahillo-Fernandez, Ignacio ;
Martin-Cleary, Catalina ;
Belen Sanz, Ana ;
Sanchez-Nino, Maria D. ;
Ortiz, Alberto .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 2016, 46 (09) :779-786
[9]   Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation and Study of Diabetic Nephropathy with Atrasentan: what was learned about the treatment of diabetic kidney disease with canagliflozin and atrasentan? [J].
Fernandez-Fernandez, Beatriz ;
Fernandez-Prado, Raul ;
Luis Gorriz, Jose ;
Martinez-Castelao, Alberto ;
Navarro-Gonzalez, Juan F. ;
Porrini, Esteban ;
Jose Soler, Maria ;
Ortiz, Alberto .
CLINICAL KIDNEY JOURNAL, 2019, 12 (03) :313-321
[10]   Albumin downregulates Klotho in tubular cells [J].
Fernandez-Fernandez, Beatriz ;
Concepcion Izquierdo, M. ;
Valino-Rivas, Lara ;
Nastou, Dimitra ;
Sanz, Ana B. ;
Ortiz, Alberto ;
Sanchez-Nino, Maria D. .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2018, 33 (10) :1712-1722