Gender differences in age-related decline in glomerular filtration rates in healthy people and chronic kidney disease patients

Background: Since men with chronic kidney disease (CKD) progress faster than women, an accurate assessment of CKD progression rates should be based on gender differences in age-related decline of glomerular filtration rate (GFR) in healthy individuals. Methods: A Chinese sample population from a stratified, multistage, and clustered CKD screening study was classified into healthy, at-risk, and CKD groups. The gender differences in estimated GFR (eGFR) and age-related eGFR decline were calculated for each group after controlling for blood pressure, fasting glucose levels, serum lipids levels, education level, and smoking status. After referencing to the healthy group, gender-specific multivariate-adjusted rates of decline in eGFR and differences in the rates of decline were calculated for both CKD and at-risk groups. Results: The healthy, at-risk, and CKD groups consisted of 4569, 7434, and 1573 people, respectively. In all the 3 groups, the multivariate-adjusted eGFRs in men were lower than the corresponding eGFRs in women. In addition, in the healthy and at-risk groups, the rates of decline in eGFR in men were lower than the corresponding rates of decline in women (healthy group: 0.51 mL.min(-1).1.73 m(-2).yr(-1) vs. 0.74 mL.min(-1).1.73 m(-2).yr(-1) and at-risk group: 0.60 mL.min(-1).1.73 m(-2).yr(-1) vs. 0.73 mL.min(-1).1.73 m(-2).yr(-1)). However, in the CKD group, the rates of decline in eGFR in men were similar to those in women (0.96 mL.min(-1).1.73 m(-2).yr(-1) vs. 0.91 mL.min(-1).1.73 m(-2).yr(-1)). However, after referencing to the healthy group, the rates of decline in eGFR in men in the at-risk and CKD groups were greater faster than the corresponding rates in women (at-risk group: 0.10 mL.min(-1).1.73 m(-2).yr(-1) vs. -0.03 mL.min(-1).1.73 m(-2).yr(-1) and CKD group: 0.44 mL.min(-1).1.73 m(-2).yr(-1) vs. 0.15 mL.min(-1).1.73 m(-2).yr(-1)). Conclusion: To accurately assess gender differences in CKD progression rates, gender differences in age-related decline in GFR should be considered.