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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Differential cardiovascular risk profiles by sex among adults with CKD: a NHANES-based analysis
Hannah T Belikoff1, Ramya Walsan2, Cara M Hildreth1
1Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
Insights
Females with chronic kidney disease (CKD) have different cardiovascular risk factors than males, including lower odds of diabetes and hypertension but higher odds of increased waist circumference. Understanding these sex-based differences is crucial for personalized CKD care.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is the leading cause of death in patients with chronic kidney disease (CKD).
- Shared risk factors contribute to the increased CVD risk in CKD patients.
- Sex-specific differences in these risk factors require further investigation.
Purpose of the Study:
- To investigate sex-based differences in cardiovascular risk factors among individuals with CKD.
- To understand how sex influences cardiovascular risk in the context of declining renal function.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) (2007-2018).
- Classified CKD based on albumin-to-creatinine ratio or estimated glomerular filtration rate (eGFR).
- Employed two-way ANOVAs and multivariable logistic regression to analyze sex-specific cardiovascular risk factors.
Main Results:
- Declining renal function in both sexes correlated with increased systolic blood pressure and decreased hemoglobin/hematocrit.
- Females with CKD had lower odds of diabetes, hypertension, low hematocrit, and elevated triglycerides compared to males.
- Females with CKD showed higher odds of increased waist circumference and low high-density lipoprotein cholesterol (HDL-C) than males.
Conclusions:
- Significant sex-based differences exist in cardiovascular risk factors among individuals with CKD.
- Females with CKD present with a distinct risk factor profile compared to males.
- Incorporating sex-specific approaches in CKD research and management is essential for personalized patient care.
Introduction:
Chronic kidney disease (CKD) and cardiovascular disease are closely interconnected, with cardiovascular disease the leading cause of death for those with CKD. This increased risk for those with CKD is partly attributed to shared risk factors between the conditions. These risk factors differ in presentation between females and males; however, further research is needed to better understand how sex influences cardiovascular risk factors among individuals with CKD.
Methods:
Data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 was utilised. CKD was classified as an albumin-to-creatinine ratio ≥30 mg/g or an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Participants were categorized into GFR categories based on their eGFR results for further analysis. Two-way ANOVAs compared means across groups, and a Tukey's post hoc test was performed to assess the statistical significance between group means. Multivariable logistic regression was used to determine the association between cardiovascular risk factors and sex among individuals with and without CKD.
Results:
A total of 30,804 participants aged 20 years and older were included, in which 5,528 were classified as having CKD. Our analyses of participants by sex and GFR categories revealed that for both females and males, as renal function declined, systolic blood pressure increased while haemoglobin and haematocrit levels decreased. Multivariate logistic regression revealed that females with CKD demonstrated reduced odds for diabetes (OR: 0.53, CI: 0.42-0.66), hypertension (OR: 0.80, CI: 0.66-0.97), low haematocrit (OR: 0.47, CI: 0.40-0.56), and elevated triglycerides (OR: 0.75, CI: 0.63-0.88), yet exhibited increased odds of a high waist circumference (OR: 1.69, CI: 1.40-2.04) and low high-density lipoprotein cholesterol (HDL-C) (OR: 1.18, CI: 1.00-1.39), compared to males with CKD.
Conclusion:
Sex-based differences in cardiovascular risk factors among individuals with CKD reveal that females have lower odds of diabetes, hypertension, low haematocrit and elevated triglycerides, but higher odds of increased waist circumference and low HDL-C compared to males. These findings highlight the need to incorporate sex-specific perspectives into CKD research and management to improve personalized care.
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