Abstract Background A persistently elevated urine albumin:creatinine ratio (uACR) for more than 90 days is a diagnostic marker of chronic kidney disease (CKD), and an independent dose-dependent risk factor for CVD mortality, atrial fibrillation, heart failure, peripheral arterial disease and stroke.1 Reducing uACR with guideline-directed medical therapies reduces this risk. Regular uACR testing in at-risk patients, such as those with diabetes or with established CKD, is essential for early risk identification and timely intervention. Purpose To explore gender differences in uACR testing in patients with established CKD across England. Methods Permission was sought from the publicly available database CVDprevent.2 Gender differences of the domain "% Patients with GP recorded CKD (G3a to G5) with a record of a urine ACR test in the preceding 12 months" was mapped across 7 geographical domains throughout England (East of England, London, Midlands, North East and Yorkshire, North West, South East, South West). The latest data set, June 2025, was used. Results uACR testing in patients with CKD was suboptimal across England. The testing differences across the 7 regions ranged from 39.48% to 54.61% in females and 47.34% to 61.27% in males. In every area, females were tested less frequently than men (average difference 6.76%). Further analysis of the use of renin-angiotensin system antagonists for patients with CKD and proteinuria showed that females are treated less often than males across all regions (average treatment difference: 6.38%). Conclusions Significant diagnostic and treatment disparities exist between females and males with CKD across England.3 This inequality extends to uACR testing, where there is a clear and persistent gender gap in CKD detection and management. Given that CKD is a major risk factor for MACE, proactive testing and management for CKD is essential to reduce cardiovascular risk and prevent avoidable complications and mortality associated with CKD.
Thakkar et al. (Mon,) studied this question.
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