CHRONIC kidney disease (CKD) is a major public health issue, with an estimated global prevalence of between 8% and 16%. Over time, the quality of care for patients with CKD has improved, which is important to delay disease progression, prevent end-stage kidney disease, and enhance clinical outcomes.
Despite this, a recent Swedish study has highlighted important gender differences in the detection, recognition, monitoring, and management of people with CKD. The investigators emphasised that differences in comorbidity burden did not explain these discrepancies.
Juan-Jesus Carrero, Professor of Epidemiology, Karolinska Institutet, Stockholm, Sweden, and colleagues, used data from the 2009–2017 Stockholm Creatine Measurements (SCREAM) project, and identified 126,289 females and 101,558 males with an estimated glomerular filtration rate below 60 mL/min per 1.73 m2, denoting probable CKD.
Over an 18 month period, the team found that females were 52% less likely to have received a CKD diagnosis and 11% less likely to have an albuminuria measurement compared with males. Females were also less likely to receive guideline-recommended medications for CKD, with a 32% and 22% decreased odds of receiving renin-angiotensin system inhibitors and statins, respectively, when compared with males.
In adjusted analyses of patients with Stage 5 CKD, women were 23% less likely than their male counterparts to see a nephrologist. Additional results indicated that women were 42% less likely to receive a nephrology referral. The researchers noted that late referral is associated with faster progression and worse outcomes.
In a prepared statement, Carrero revealed: “We were expecting to find small or no disparities in how men and women were managed, because guidelines do not make distinctions by sex.” He continued: “Instead, we observed profound differences in the detection work up and management of chronic kidney disease suggesting suboptimal care among women.”
Going forward, efforts to address the gender disparities in clinical practice and ensure equitable care between males and females could facilitate a reduction in the burden of CKD.
