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Sex disparities and adverse cardiovascular and kidney outcomes in patients with chronic kidney disease: results from the KNOW-CKD

 Chan-Young Jung  ;  Ga Young Heo  ;  Jung Tak Park  ;  Young Su Joo  ;  Hyung Woo Kim  ;  Hyunsun Lim  ;  Tae Ik Chang  ;  Ea Wha Kang  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang  ;  Joongyub Lee  ;  Soo Wan Kim  ;  Yun Kyu Oh  ;  Ji Yong Jung  ;  Kook-Hwan Oh  ;  Curie Ahn  ;  Seung Hyeok Han 
 CLINICAL RESEARCH IN CARDIOLOGY, Vol.110(7) : 1116-1127, 2021-07 
Journal Title
Issue Date
Cardiovascular events ; Chronic kidney disease ; Disparities ; Mortality ; Sex
Aims: Longitudinal studies of the association between sex and adverse clinical outcomes in patients with chronic kidney disease (CKD) are scarce. We assessed whether major outcomes may differ by sex among CKD patients.

Methods: We analyzed a total of 1780 participants with non-dialysis CKD G1-5 from the KoreaN cohort study for Outcome in patients with Chronic Kidney Disease (KNOW-CKD). The primary outcome was a composite of non-fatal cardiovascular events or all-cause mortality. Secondary outcomes included fatal and non-fatal cardiovascular events, all-cause mortality, and a composite kidney outcome of ≥ 50% decline in estimated glomerular filtration rate from baseline or the onset of end-stage kidney disease.

Results: There were 1088 (61%) men and 692 (39%) women in the study cohort. The proportion of smokers was significantly higher in men (24% vs. 3%). During 8430 person-years of follow-up, 201 primary outcome events occurred: 144 (13%) in men and 57 (8%) in women, with corresponding incidence rates of 2.9 and 1.7 per 100 person-years, respectively. In multivariable Cox models, men were associated with a 1.58-fold (95% CI 1.06-2.35) higher risk of composite outcome. Propensity score matching analysis revealed similar findings (HR 1.81; 95% CI 1.14-2.91). Risk of all-cause mortality was significantly higher in men of the matched cohort. However, there was no difference in the risk of CKD progression. In the subgroup with coronary artery calcium (CAC) measurements, men had a higher likelihood of CAC progression.

Conclusions: In Korean CKD patients, men were more likely to experience adverse cardiovascular events and death than women.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Jung, Chan-Young(정찬영) ORCID logo https://orcid.org/0000-0002-2893-9576
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
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