1. The rate of progression of renal disease may not be slower in women compared with men
- Author
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Robert D. Toto, Andrew S. Levey, Christopher H. Schmid, Paul E. de Jong, Svend Strangaard, Tazeen H. Jafar, Carmelita Marcantoni, Anne Lise Kamper, Giuseppe Remuzzi, Shahnaz Shahinfar, Piero Ruggenenti, Paul Stark, Dick de Zeeuw, Gavin J. Becker, and Groningen Kidney Center (GKC)
- Subjects
Male ,IGA NEPHROPATHY ,Angiotensin-Converting Enzyme Inhibitors ,RANDOMIZED CONTROLLED TRIAL ,BLOOD-PRESSURE ,Severity of Illness Index ,chemistry.chemical_compound ,INSUFFICIENCY ,gender ,FAILURE ,Randomized Controlled Trials as Topic ,Incidence ,Age Factors ,PROTEINURIA ,renal disease progression ,Middle Aged ,Prognosis ,Survival Rate ,Nephrology ,ENALAPRIL ,Disease Progression ,Female ,Adult ,medicine.medical_specialty ,chronic renal disease ,INHIBITION ,Risk Assessment ,Sex Factors ,Internal medicine ,Severity of illness ,medicine ,Humans ,Survival rate ,Aged ,Probability ,Proportional Hazards Models ,Transplantation ,Creatinine ,Proportional hazards model ,business.industry ,ANGIOTENSIN-CONVERTING-ENZYME ,medicine.disease ,Confidence interval ,Surgery ,Blood pressure ,chemistry ,Relative risk ,Kidney Failure, Chronic ,business ,Kidney disease - Abstract
Background. Some studies suggest that progression of renal disease is slower in women than in men. However, other factors that are also associated with progression of renal disease have not always been taken into account. Therefore, we undertook this analysis to explore the independent association of renal disease progression with gender.Methods. We analysed a pooled database of patients with non-diabetic renal disease enrolled in 11 randomized controlled trials evaluating the efficacy of angiotensin-converting enzyme inhibitors (ACEIs) for slowing renal disease progression. The primary end point was the combined outcome of doubling of baseline serum creatinine or onset of end-stage renal disease (ESRD). The secondary end point was the onset of ESRD alone. We performed multivariable Cox proportional hazards analysis to study the independent effect of gender on these end points after adjusting for baseline patient characteristics, and changes from baseline to follow-up systolic blood pressure (SBP) and urine protein (UP) excretion.Results. The total number of patients was 1860: 645 (35%) females and 1215 (65%) males. Mean duration of follow-up was 2.2 years. The proportions randomized to ACEI (51%), mean baseline serum creatinine (2.2 mg/dl) and mean age (52 years) were similar for both genders. Mean baseline SBP was greater in women than in men: 151 vs 147 mmHg (P Conclusions. Our findings suggest that the rate of renal disease progression may not be slower, and may even be faster in women compared with men, after adjusting for other factors associated with a faster rate of progression. We caution that most women in our database were of post-menopausal age, and thus our findings may not extend to younger women.
- Published
- 2003