Female sex was associated with lower odds of receiving renin-angiotensin system inhibitors (OR 0.75; 95% CI 0.64-0.88) and SGLT2 inhibitors (OR 0.79; 95% CI 0.64-0.98) compared to male sex in CKD.
Cohort (n=4,192)
Yes
Does female sex reduce the likelihood of receiving evidence-based medications in patients with CKD?
Female patients with CKD are significantly less likely to receive evidence-based therapies such as RASi and SGLT2i compared to males, highlighting potential global inequities in treatment.
Odds Ratio: 0.75 (95% CI 0.64–0.88)
p-value: p=<0.001
Abstract Background and Hypothesis Chronic kidney disease (CKD) is a growing global health burden. While studies have demonstrated sex disparities in CKD prevalence and outcomes, evidence on sex-based differences in therapeutic management remains limited. This analysis aims to assess sex disparities in the receipt of evidence-based medications in a global CKD cohort. Methods This study is a sub-study of the Global Kidney Patient Trials Network (GKPTN), a prospective, observational, international cohort of CKD patients. The exposure of this study is biological sex, and the main outcomes are the receipt of evidence-based medications for CKD, including renin-angiotensin system inhibitors (RASi), sodium glucose co-transporter 2 inhibitor (SGLT2i) and diuretics. Adjusted multivariable logistic models were conducted to examine associations between sex and proportion of receiving medications, as well as the interactions between sex and other key clinical characteristics (advanced age, high KDIGO prognosis risk, and comorbid condition). Results A total of 4192 participants were eligible, and 40.9% were female. Females had lower odds of receiving RASi (OR = 0.75, 95% CI 0.64–0.88; P 0.001) and SGLT2i (OR = 0.79, 95% CI 0.64–0.98; P = 0.03) compared to males, after adjusting for age, region, systolic blood pressure (SBP), body mass index (BMI), presence of cardiovascular disease and diabetes, CKD aetiology and prognosis risk, with no significant difference in the receipt of diuretics. There were no significant interactions between sex and any other key clinical characteristics, indicating that the disparities in the receipt of RASi and SGLT2i remained consistent across high-risk subgroups. Conclusion Female patients with CKD are less likely to receive evidence-based medications than males, irrespective of established CKD risk factors. This difference highlights potential inequities in treatment globally which may result in outcome disparities.
Du et al. (Tue,) conducted a cohort in Chronic kidney disease (CKD) (n=4,192). Female sex vs. Male sex was evaluated on Receipt of renin-angiotensin system inhibitors (RASi) (OR 0.75, 95% CI 0.64-0.88, p=<0.001). Female sex was associated with lower odds of receiving renin-angiotensin system inhibitors (OR 0.75; 95% CI 0.64-0.88) and SGLT2 inhibitors (OR 0.79; 95% CI 0.64-0.98) compared to male sex in CKD.