The influence of sex on renal function decline in people with Type 2 diabetes.

Aims Several reports have suggested a relationship between male sex and albuminuria in Type 2 diabetes, but impact on renal function decline has not been established. Our aim was to describe the influence of sex on renal function decline in Type 2 diabetes. Methods SURDIAGENE, an inception cohort, consisted in 1470 people with Type 2 diabetes. Patients without renal replacement therapy and with ≥ 3 serum creatinine determinations during follow-up prior to end-stage renal disease were included in the study. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Primary outcome was steep estimated glomerular filtration rate ( eGFR) decline, defined as a yearly slope value lower than -3.5 ml min⁻¹ 1.73 m⁻². Secondary outcomes were estimated glomerular filtration rate trajectories according to sex and occurrence of end-stage renal disease. Results A total of 22 914 serum creatinine determinations were considered in 1146 participants (60% men), aged 65 ± 11 years, with a median follow-up duration of 5.7 years (range 0.1-10.2). Median yearly estimated glomerular filtration rate slope was -1.31 ml min⁻¹ 1.73 m⁻² in women and -1.77 ml min⁻¹ 1.73 m⁻² in men ( P < 0.001). Men were more likely than women to develop end-stage renal disease (22 men vs. 7 women; P_log-rank = 0.03). Male sex was an independent risk factor of steep estimated glomerular filtration rate decline [adjusted odds ratio = 1.33 (1.02-1.76), P = 0.04] after adjustment for age, time from diagnosis of Type 2 diabetes, glycated haemoglobin, systolic blood pressure and urinary albumin:creatinine ratio. A multivariable linear mixed-effects model showed a significant difference of estimated glomerular filtration rate trajectories between men and women ( P < 0.001). Conclusion Male sex is an important independent factor associated with renal function decline in Type 2 diabetes. [ABSTRACT FROM AUTHOR]