We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Abbott Diagnostics

Download Mobile App




Events

18 Nov 2019 - 21 Nov 2019
02 Dec 2019 - 06 Dec 2019

Proteinuria Contributes to Greater CKD Progression Risk in Men

By Labmedica International staff writers
Posted on 29 Aug 2019
Print article
Image: A photomicrograph showing numerous completely sclerotic glomeruli and severe chronic tubulointerstitial nephritis from a patient with end-stage kidney disease (Photo courtesy of Dr. Jian-Hua Qiao, MD, FCAP).
Image: A photomicrograph showing numerous completely sclerotic glomeruli and severe chronic tubulointerstitial nephritis from a patient with end-stage kidney disease (Photo courtesy of Dr. Jian-Hua Qiao, MD, FCAP).
Older men with chronic kidney disease had a 50% increased risk for progression to end-stage kidney disease (ESKD) compared with women and this may be the result of higher levels of proteinuria.

End stage kidney disease is the last stage (stage five) of chronic kidney disease (CKD). This means kidneys are only functioning at 10% to 15% of their normal capacity. When kidney function is this low, they cannot effectively remove waste or excess fluid from the blood.

A team of scientists working with the University of Campania (Naples, Italy) evaluated the impact of gender on CKD progression, and conducted a pooled analysis of four observational cohort studies, which included a total of 2,335 men and women with an eGFR of less than 45 mL/min/1.73m2 (mean age, 67.1 years; mean eGFR, 26.9 mL/min/1.73m2). While age, systolic blood pressure and use of renin-angiotensin system inhibitors were similar between men and women, women had a lower median proteinuria (protein excretion, 0.45 g/d) compared with men (0.69 g/d).

The team reported that during a median follow-up of 4.2 years, 757 developed ESKD (59.4% men) and 471 died (58.4% men). The adjusted risks for ESKD and mortality were higher in men (Hazard Ratios (HRs) of 1.50 and 1.30 respectively). This finding was consistent across CKD stages. They observed a significant interaction between gender and proteinuria, with the risk for ESKD in men being significantly greater than for women at a level of proteinuria of ∼0.5 g/d or greater. When examining eGFR, they concluded that the slope of decline in eGFR was steeper in men than in women and that the difference in slopes between men and women was progressively larger with proteinuria less than 0.50 g/d.

The team concluded that data obtained from patients with clinical features consistent with the epidemiologic pattern of the present CKD population worldwide, namely advanced age and high prevalence of diabetes and cardiovascular disease. Still, although their study had some limitations, the results derive from a population of referred white patients with CKD and therefore findings may not hold true for other ethnic groups. Despite this limitation, proteinuria levels may modify the association between sex and renal risk.

Roberto Minutolo, MD, PhD, a Professor of Nephrology, and lead author of the study said, “The importance of sexual dimorphisms has been observed for hypertension and cardiovascular complications with regard to disease presentation, likelihood of progression to advanced phases and response to treatment. To date, the impact of sex on CKD remains poorly defined. In this setting, the mechanisms underlying the observed sex disparity in the epidemiology of kidney diseases have not been fully elucidated.” The study was published on August 10, 2019, in the American Journal of Kidney Diseases.

Related Links:
University of Campania


Print article

Channels

Molecular Diagnostics

view channel
Image: The fluorescence fingerprinting device can test saliva for the presence of the synthetic cannabinoid receptor agonist “spice” in about five minutes (Photo courtesy of University of Bath)

Rapid Fluorescence Fingerprinting Assay for Identification of Synthetic Cannabinoid Receptor Agonists

A team of British researchers developed a rapid real-time, point-of-care test for the identification of synthetic cannabinoid receptor agonists (SCRAs), a class of illegal drugs known colloquilly as “Spice” or “K2”.... Read more

Hematology

view channel
Image: A blood film showing neutrophils and lymphocytes and other white and red blood cells, and a platelet (Photo courtesy of University of Minnesota).

Hematological Ratios Associated with Mortality in Pediatric Trauma Patients

Trauma-related injury as a potential cause of death affects millions of people worldwide, especially in less developed countries and furthermore, it is the leading cause of mortality in pediatric trauma patients.... Read more
Copyright © 2000-2019 Globetech Media. All rights reserved.