Sex Differences in Kidney Function Decline in the Healthy General Population.

Area of Science:

• Nephrology
• Gerontology
• Epidemiology

Background:

• Chronic kidney disease (CKD) shows significant sex and gender disparities in prevalence, with Stage 3 CKD more common in women.
• The reasons for this epidemiological paradox, particularly concerning age-related decline in glomerular filtration rate (GFR), remain incompletely understood.
• Existing research on sex differences in GFR decline is limited and often relies on estimated GFR (eGFR) using creatinine or cystatin C.

Purpose of the Study:

• To review existing literature on age-related GFR decline in men and women.
• To explore potential sex-based differences in GFR trajectories and their contribution to CKD prevalence disparities.
• To identify factors influencing GFR decline and highlight gaps in current knowledge.

Main Methods:

• Systematic review of studies investigating age-related GFR decline in general populations.
• Analysis of methodologies used to assess GFR, including measured GFR and various eGFR equations.
• Examination of study population characteristics, focusing on comorbidities and risk factors.

Main Results:

• Findings on sex differences in GFR decline are conflicting and inconsistent across studies.
• Variations in study populations (e.g., comorbidities) and GFR assessment methods likely contribute to conflicting results.
• Current eGFR equations may not accurately reflect sex-specific GFR decline patterns.

Conclusions:

• Sex and gender differences in GFR levels and decline rates may play a role in observed CKD prevalence differences.
• Potential contributing factors include biological elements (e.g., sex hormones), GFR assessment methods, and differing risk factor profiles.
• Further research is crucial to elucidate sex-specific GFR decline trajectories and their clinical implications for CKD.