The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis

Abstract

Background Hypertension (HTN) is an established risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). Whether sex differences in the effect of HTN on CKD and ESRD incidence exist remains unclear. This systematic review and meta-analysis was conducted to evaluate the relative impact of HTN on CKD and ESRD risk in women compared with men. Methods We systematically searched Embase and PubMed for cohort studies until 24 July 2020. Studies were selected if they reported a sex-specific association between systolic blood pressure (SBP) and CKD or ESRD. Random effects meta-analyses with inverse variance weighting were used to pool sex-specific relative risks (RRs) and the women-to-men ratio of RRs (the RRR) for incident CKD and ESRD. Results Data from six cohorts, including 2,382,712 individuals and 6856 incident CKD events, and 833 ESRD events, were included in the meta-analysis. The RR for incident CKD or ESRD associated with HTN (SBP ≥140 mmHg) versus ideal BP (SBP < 120 mmHg) was 1.56 (95% CI, 1.39–1.75) in women and 2.06 (95% CI, 1.64–2.60) in men. The RR for incident CKD or ESRD was 23% lower in women than in men RRR 0.77 [95% CI, 0.63–0.95] with no significant heterogeneity between studies (p-value for Q test = 0.507, I2 = 17.7%). Conclusion HTN confers about a fifth lower excess risk of incident CKD or ESRD in women than men. Sex differences in onset, duration, and severity of some risk factors, such as albuminuria, diabetes, cardiovascular disease, obesity, and socioeconomic status, may explain part of the excess risk in men. Another explanation could be that women might be under-diagnosed and less likely to initiate dialysis. Future studies are needed to demonstrate the mechanisms responsible for the observed sex difference.

Resveratrol Butyrate Ester Protects Adenine-Treated Rats against Hypertension and Kidney Disease by Regulating the Gut–Kidney Axis

“…We also demonstrated that RBE exhibits a higher antioxidant capacity than resveratrol itself [ 17 ]. Given that RBE has been shown to produce highly beneficial biological effects [ 18 ], the aim of the current study was: to (1) evaluate the effectiveness of RBE at low and high doses vs. resveratrol in the treatment of hypertension in a model of pediatric CKD; and (2) elucidate the mechanisms related to the beneficial effects, with a focus on the gut-kidney axis.…”

Correction to: The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis

“…Following publication of the original article [ 1 ], the authors informed us that there are some errors due to a typesetting mistake. The corrections are as follows: Figure 1 has been updated as the arrows in the figure were distorted during the production process.…”

Combined Effects of Dyslipidemia and High Adiposity on the Estimated Glomerular Filtration Rate in a Middle-Aged Chinese Population

“…This disparity is unlikely to be explained by biological differences alone. 44 We speculate that male subjects have significantly worse lifestyles in the present study, and the prevalence of underlying diseases is also significantly higher, such as hypertension, dyslipidemia, and obesity. The above factors may be related to the significantly lower baseline eGFR in men, and the significant discrepancies in the abovementioned baseline indicators might also contribute to the sex difference of the present results.…”