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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease IV: Nursing Management01:18

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Chronic Obstructive Pulmonary Disease01:24

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COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
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Updated: Feb 7, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Sex-Associated Biomarker Differences in CKD Progression and Mortality.

Thomas McDonnell1,2, Anthony Onoja3, Nicolas Vuilleumier4

  • 1Donal O'Donoghue Renal Research Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom.

Clinical Journal of the American Society of Nephrology : CJASN
|February 5, 2026
PubMed
Summary

Men with chronic kidney disease (CKD) face higher risks of kidney failure and death. Biomarker differences, particularly in inflammation and matrix deposition, explain these sex-based outcome disparities, suggesting a biological basis for worse male CKD prognosis.

Keywords:
CKD nondialysisbiomarkersgender differencemortalitymortality riskrenal progression

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Area of Science:

  • Nephrology and Urology
  • Biomarkers and Diagnostics
  • Sex-Based Medicine

Background:

  • Males with chronic kidney disease (CKD) exhibit poorer outcomes compared to females.
  • This disparity is not fully explained by comorbidities or sociocultural factors.
  • Investigating sex-based differences in biomarkers may elucidate the underlying risk mechanisms.

Purpose of the Study:

  • To explore whether sex-based differences in specific biomarkers contribute to the observed disparity in CKD outcomes between males and females.
  • To identify specific biomarkers associated with kidney injury, fibrosis, inflammation, and cardiovascular stress that differ between sexes in CKD patients.

Main Methods:

  • Analysis of 1,680 males and 1,204 females with non-dialysis-dependent CKD from the NURTuRE-CKD cohort.
  • Measurement of 21 biomarkers related to kidney injury, fibrosis, inflammation, and cardiovascular stress.
  • Utilized multivariable Cox and Fine and Gray models for outcome assessment and ANCOVA for biomarker comparisons, adjusting for clinical factors.

Main Results:

  • Significant sex differences in biomarker concentrations were observed in both controls and CKD participants.
  • Males with CKD showed higher levels of inflammatory and extracellular matrix deposition biomarkers (e.g., KIM-1, GDF-15).
  • Females with CKD had higher levels of matrix turnover and degradation markers (e.g., Osteoactivin, MMP-9).
  • After adjusting for biomarker differences, the elevated risk of kidney failure and mortality associated with male sex was eliminated.

Conclusions:

  • Male sex is independently associated with increased risk for kidney failure and mortality in CKD patients.
  • Sex-specific biomarker profiles, reflecting distinct biological pathways, underlie these outcome differences.
  • Adjustment for these biomarkers neutralizes the increased risk in males, highlighting a biological basis for sex disparities in CKD.
  • Findings suggest potential for sex-specific therapeutic targets in CKD management.