Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes

Kajiwara, Ayami; Kita, Ayana; Saruwatari, Junji; Miyazaki, Hiroko; Kawata, Yuki; Morita, Kazunori; Oniki, Kentaro; Yoshida, Akira; Jinnouchi, Hideaki; Nakagawa, Kazuko

doi:10.1155/2016/4626382

Cited by 36 publications

(32 citation statements)

References 31 publications

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“…56 In a small (247 male, 97 female adults with T2DM) clinic-based, retrospective longitudinal study (follow-up duration, 8.1AE1.4 years), the mean annual eGFR change was À3.5AE2.7%/year in females and À2.0AE2.2%/year in males. 49 This eGFR decline was associated with HbA 1c and lowdensity lipoproteinecholesterol levels, but only in females, suggesting a need for a more aggressive therapeutic intervention to improve metabolic profiles at early stage, especially in females. Another study, conducted in women with T2DM (mean age, 61.6AE6.8 years; duration of diabetes, 9.8AE7.2 years) found that the early renal functional decline in these women is linked to increased vascular stiffness, which may be associated with visceral fat accumulation as determined by waist circumference.…”

Section: Evidence For the Female Sex As A Risk Factor For Dkd Associamentioning

confidence: 89%

“…Kajiwara et al 49 The mean decline in annual eGFR was -3.5AE2.7%/year in females and -2.0AE2.2%/year in males (P<0.001) and was associated with HbA 1c and low-density lipoprotein cholesterol levels, but only in women.…”

Section: Greater Risk In Womenmentioning

confidence: 95%

“…Although not abundant, data on the impact of sex on DKD in patients with T2DM seems to be just as inconclusive and inconsistent as in patients with T1DM, with studies reporting either higher risk of DKD in men, [45][46][47][48] women, [49][50][51][52][53][54] or no sex differences. 17,55 Findings from these studies are discussed below and summarized in Table 2.…”

Section: Kidney Disease Associated With T2dmmentioning

confidence: 99%

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Sex Differences in Diabetic Kidney Disease

Maric‐Bilkan

2020

Mayo Clinic Proceedings

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While the global prevalence of both type 1 and type 2 diabetes mellitus is similar in men and women, the consequences of diabetes on associated end-organ complications, including diabetic kidney disease appear to be more sex-specific. Particularly, women with diabetes have higher mortality rates for diabetes-related deaths, and higher prevalence of diabetic kidney disease risk factors such as hypertension, hyperglycemia, obesity, and dyslipidemia. However, the evidence for the impact of sex on diabetic kidney disease prevalence and disease progression is limited and inconsistent. Although most studies agree that the protective effect of the female sex against the development of kidney disease is diminished in the setting of diabetes, the reasons for this observation are unclear. Whether or not sex differences exist in the risk of diabetic kidney disease is also unclear, with studies reporting either higher risk in men, women, or no sex differences. Despite the remaining controversies, some of the factors that associate with sex differences in the risk of diabetic kidney disease are age at onset, and type and duration of diabetes. There is growing appreciation of the importance of sex hormones in the regulation of renal function, with estrogens generally considered to be renoprotective. Although some progress has been made towards better understanding of the mechanisms by which sex hormones play a role in the pathophysiology of diabetic kidney disease, the translational potential

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Section: Evidence For the Female Sex As A Risk Factor For Dkd Associamentioning

confidence: 89%

Section: Greater Risk In Womenmentioning

confidence: 95%

Section: Kidney Disease Associated With T2dmmentioning

confidence: 99%

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Sex Differences in Diabetic Kidney Disease

Maric‐Bilkan

2020

Mayo Clinic Proceedings

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“…A recent study determined that females with chronic kidney disease (CKD) had a slower decline in glomerular filtration rate (GFR), lower risk of progression to end-stage renal disease (ERSD), and a lower risk of death compared to age-matched men with similar mild-to-moderate CKD [42]. In diabetic kidney disease, men tended to demonstrate renal complications roughly 10 years earlier than women [40], while sex differences in obesity-related kidney disease [43][44][45] demonstrated that female sex hormones may safeguard against worsening pathology [45]. Thus, being female may have a protective effect on the kidney, preventing women from developing the more severe phenotypes observed in men.…”

Section: Urate As a Risk Factor In Diseasementioning

confidence: 99%

Sex Differences in Urate Handling

Kuhns

Woodward

2020

IJMS

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Hyperuricemia, or elevated serum urate, causes urate kidney stones and gout and also increases the incidence of many other conditions including renal disease, cardiovascular disease, and metabolic syndrome. As we gain mechanistic insight into how urate contributes to human disease, a clear sex difference has emerged in the physiological regulation of urate homeostasis. This review summarizes our current understanding of urate as a disease risk factor and how being of the female sex appears protective. Further, we review the mechanisms of renal handling of urate and the significant contributions from powerful genome-wide association studies of serum urate. We also explore the role of sex in the regulation of specific renal urate transporters and the power of new animal models of hyperuricemia to inform on the role of sex and hyperuricemia in disease pathogenesis. Finally, we advocate the use of sex differences in urate handling as a potent tool in gaining a further understanding of physiological regulation of urate homeostasis and for presenting new avenues for treating the constellation of urate related pathologies.

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“…In studies that enrolled patients with type 2 diabetes, it seems that more results indicated female has greater risk of DKD progression [8] . A study from Japan [12] (247 male and 97 female)…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Biopsy-confirmed Diabetic Kidney Disease

Wang

Zhang

et al. 2020

Preprint

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Background: To investigate the association between sex differences and end-stage kidney disease (ESKD) in patients with biopsy-confirmed diabetic kidney disease (DKD). Method: We performed a retrospective cohort study. A total of 336 patients with biopsy-confirmed DKD who were followed up for at least 12 months were enrolled. Baseline clinical and pathological data were collected. ESKD was defined by an estimated glomerular filtration rate of <15 mL/min/1.73m 2 or initiation of renal replacement therapy. The association between sex differences and ESKD was assessed using the log-rank test and Cox regression. Result: There were 239 (71%) male and 97 (29%) female patients in our cohort. Female patients had higher systolic blood pressure, total cholesterol and low-density lipoprotein cholesterol levels, but relatively mild renal interstitial inflammation, compared with male. There was a lower proportion of female patients in the very high risk grade according to the chronic kidney disease categories. During a median follow-up time of 20 months, 101 (57.7%) men and 43 (44.3%) women entered into ESKD, with no significant difference by the log-rank test. Univariant and multivariant Cox regression further showed that sex difference was not associated with ESKD. Conclusion: Female patients had the higher systolic blood pressure, total cholesterol, LDL-C, but relatively mild renal interstitial inflammation, compared with male patients. However, there does not appear to be an association between sex difference and ESKD in our study.

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Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes

Cited by 36 publications

References 31 publications

Sex Differences in Diabetic Kidney Disease

Sex Differences in Diabetic Kidney Disease

Sex Differences in Urate Handling

Sex Differences in Biopsy-confirmed Diabetic Kidney Disease

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