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

Jung, Chan-Kwon; Heo, Ga Young; Park, Sun-Hee; Joo, Young Su; Kim, Hyung Woo; Lim, Hyunsun; Chang, Tae Ik; Kang, Ea Wha; Yoo, Tae‐Hyun; Kang, Shin Wook; Lee, Joongyub; Kim, Soo Wan; Oh, Yun Kyu; Jung, Ji Yong; Oh, Kook Hwan; Ahn, Curie; Han, Seung Hyeok

doi:10.1007/s00392-021-01872-5

Cited by 16 publications

(10 citation statements)

References 47 publications

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“…CV events, either fatal or non-fatal, included any coronary artery event (unstable angina, myocardial infarction, or coronary intervention/surgery), hospitalization for heart failure, ischemic or hemorrhagic stroke, incident peripheral arterial disease, and symptomatic arrhythmia. Progression of CAC was defined as an increase in CACS of more than 200 AUs during a 4-year follow-up ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

Suh

Choi

et al. 2022

Front. Cardiovasc. Med.

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Background: Serum adiponectin level predicts cardiovascular (CV) outcomes and progression of coronary artery calcification (CAC) in the general population, although the association has not been validated in patients with chronic kidney disease (CKD). In this study, we investigated the association of high serum adiponectin level with the risk of adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD.Methods: A total of 1,127 patients with pre-dialysis CKD from a nationwide prospective cohort of patients with pre-dialysis CKD in Korea were divided into the tertile by serum adiponectin level at the baseline. CV outcome of interest was fatal and non-fatal CV events and all-cause mortality. Progression of CAC was defined as coronary artery calcium score (CACS) change more than 200 during a 4-year follow-up.Results: Cox regression analysis revealed that high serum adiponectin is associated with increased risk of fatal and non-fatal CV events (adjusted hazard ratio 2.799, 95% CI 1.348–5.811). In contrast, high serum adiponectin level was not significantly associated with all-cause mortality (adjusted hazard ratio 0.655, 95% CI 0.203–2.113). Binary logistic regression analysis revealed that high serum adiponectin level is also associated with increased risk of progression of CAC (adjusted odds ratio [OR] 2.078, 95% CI 1.014–4.260). Subgroup analyses demonstrated that the association of high serum adiponectin with increased risk of fatal and non-fatal CV events is not modified by age, gender, history of diabetes, estimated glomerular filtration rate (eGFR), or spot urine albumin-to-creatinine ratio (ACR).Conclusions: High serum adiponectin level is associated with adverse CV outcomes and progression of CAC in patients with pre-dialysis CKD.

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Section: Methodsmentioning

confidence: 99%

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

Suh

Choi

et al. 2022

Front. Cardiovasc. Med.

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“…Some studies in the past showed that either too high or too low levels of 25(OH)D could cause a poor prognosis [110,111], but subsequent studies found no definite correlation between 25(OH)D levels and outcome [112,113]. More research indicates that raising calcium levels in the blood as a result of vitamin D supplementation may be the main cause of the poor prognosis [114][115][116][117][118]. Additionally, a previous study recommended that vitamin K2 could assist in putting calcium in the hard tissues rather than the soft tissues, minimizing the likelihood of calcium-related side effects [119].…”

Section: Side Effects Of Excess Vitamin Dmentioning

confidence: 99%

The Role of Vitamin D in SARS-CoV-2 Infection and Acute Kidney Injury

Hsieh

Hsiao

Liao

et al. 2022

IJMS

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Vitamin D has been described as an essential nutrient and hormone, which can cause nuclear, non-genomic, and mitochondrial effects. Vitamin D not only controls the transcription of thousands of genes, directly or indirectly through the modulation of calcium fluxes, but it also influences the cell metabolism and maintenance specific nuclear programs. Given its broad spectrum of activity and multiple molecular targets, a deficiency of vitamin D can be involved in many pathologies. Vitamin D deficiency also influences mortality and multiple outcomes in chronic kidney disease (CKD). Active and native vitamin D serum levels are also decreased in critically ill patients and are associated with acute kidney injury (AKI) and in-hospital mortality. In addition to regulating calcium and phosphate homeostasis, vitamin D-related mechanisms regulate adaptive and innate immunity. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have a role in excessive proinflammatory cell recruitment and cytokine release, which contribute to alveolar and full-body endothelial damage. AKI is one of the most common extrapulmonary manifestations of severe coronavirus disease 2019 (COVID-19). There are also some correlations between the vitamin D level and COVID-19 severity via several pathways. Proper vitamin D supplementation may be an attractive therapeutic strategy for AKI and has the benefits of low cost and low risk of toxicity and side effects.

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“…[20][21][22] Our study revealed that CKD due to glomerulonephritis caused the higher burden including the incidence rate (p < .0001 Another survey suggested that, in comparison to women, men were more likely to have a composite outcome of non-fatal cardiovascular events or all-cause death. 24 Moreover, there was proof of significant gender discrepancies in access to CKD therapy. 15 According to Spearman correlation analysis, the gender difference in CKD caused by glomerulonephritis was negatively correlated with SDI.…”

Section: Discussionmentioning

confidence: 99%

“…The indirect renoprotective effect was mediated via melatonin effect induction 23 . Another survey suggested that, in comparison to women, men were more likely to have a composite outcome of non‐fatal cardiovascular events or all‐cause death 24 . Moreover, there was proof of significant gender discrepancies in access to CKD therapy 15 .…”

Section: Discussionmentioning

confidence: 99%

Gender and socioeconomic disparities in global burden of chronic kidney disease due to glomerulonephritis: A global analysis

Bai

Yang

et al. 2023

Nephrology

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Aim: To investigate the gender and socioeconomic disparities in the global burden of chronic kidney disease (CKD) due to glomerulonephritis from 1990 to 2019.Methods: Data were extracted from the global burden of diseases (GBD) 2019 study, including incidence, prevalence and disability-adjusted life-years (DALYs). Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in age-standardized rate (ASR) of CKD due to glomerulonephritis. Paired t-test, paired Wilcoxon signed-rank test and Spearman correlation were performed to analyse the association and gender disparity in CKD due to glomerulonephritis.Results: Globally, incident cases of CKD due to glomerulonephritis increased 81% from 9 557 397 in 1990 to 17 308 071 in 2019. The age-standardized incidence rate increased by 1.47 compared with 1990 and DALYs increased by 1.35 compared with 1990 (per 100 000). The number of patients with CKD due to glomerulonephritis in low-middle SDI (3829917) and middle SDI (6268817) regions accounts for more than 55% of the total cases. CKD due to glomerulonephritis caused a higher burden including the incidence rate (p < .0001) and DALY rate (p < .0001) in men compared to women.The age-standardized DALY rate was negatively correlated with SDI (ρ = À0.64, p < .001). In the analysis of risk factors for DALYs, male individuals had a larger burden of hypertension, high BMI and high sodium diet in the DALY rates than female subjects. Conclusion:The burden of CKD due to glomerulonephritis was more skewed towards developing and less developed economies and differed by gender, so certain nations should implement far more focused and targeted policies.

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

Cited by 16 publications

References 47 publications

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

Association of High Serum Adiponectin Level With Adverse Cardiovascular Outcomes and Progression of Coronary Artery Calcification in Patients With Pre-dialysis Chronic Kidney Disease

The Role of Vitamin D in SARS-CoV-2 Infection and Acute Kidney Injury

Gender and socioeconomic disparities in global burden of chronic kidney disease due to glomerulonephritis: A global analysis

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