Archive \ Volume.13 2022 Issue 2

Gender Differences in Chronic Kidney Disease. Findings from a Two Center Study in Nigeria

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Gender differences have been known to exist both in physiologic and pathological states including kidney disease. There is a need to be well acquitted with these differences to enhance preventive and curative strategies for kidney diseases. One hundred and forty-four participants with chronic kidney disease, stage 3 to non-dialytic 5 had urine, blood, and radiological investigations to assess albuminuria, kidney function, and sizes. The findings were compared on a gender basis. Eighty-two males and 62 females participated. The mean age of the males and females were 47.9 ± 16.8 years and 50.5 ± 14.73 years respectively. A greater proportion of participants 65 years and older were females. Chronic interstitial nephritis was more common in females while chronic glomerulonephritis was more common in males. Hyponatremia, metabolic acidosis, and hyperphosphatemia were more common in females. Men used vitamin D analogs and erythropoietin more than women while women used sodium bicarbonate and phosphate binders more than men. Aging (OR-3.28, CI-2.69-387), hyponatremia (OR-4.74, CI-2.10-6.33), hypoalbuminemia ((OR-4.56, CI-3.45-7.49)), and metabolic acidosis (OR-4.14, CI-1.46-4.92) were independently associated with the female gender. Gender differences exist in the risk profile, epidemiology, laboratory findings, and response to treatment of CKD sufferers. Women had more hyponatremia and hyperphosphatemia while men had higher albumin and kidney sizes. Gender partitioned median range cut-offs of some variables would be needed for effective prevention, treatment, and follow-up of CKD sufferers.

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Uduagbamen PK, AdebolaYusuf AO, Ahmed SI, Thompson MU, Alalade BA, Ogunmola MI, et al. Gender Differences in Chronic Kidney Disease. Findings from a Two Center Study in Nigeria. Arch Pharm Pract. 2022;13(2):69-77.
Uduagbamen, P. K., AdebolaYusuf, A. O., Ahmed, S. I., Thompson, M. U., Alalade, B. A., Ogunmola, M. I., Falana, T. E., Omokore, O. A., & Emmanuel, C. C. (2022). Gender Differences in Chronic Kidney Disease. Findings from a Two Center Study in Nigeria. Archives of Pharmacy Practice, 13(2), 69-77.

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1.        Ricardo AC, Yang W, Sha D, Appel LJ, Chen J, Krousel-Wood M, et al. Sex-Related Disparities in CKD Progression. J Am Soc Nephrol. 2019;30(1):137-46. 

2.        Nitsch D. Is there a difference in metabolic burden between men and women?. Nephrol Dial Trans. 2014;29(6):1110-2.

3.        Oliva MM, Gambioli R, Forte G, Porcaro G, Aragona C, Unfer V. Unopposed estrogens: current and future perspectives. Eur Rev Med Pharmacol Sci 2022;26(8):2975-89. doi:10.26355/eurrev20220428629

4.        Verzola D, Gandolfo MT, Salvatore F, Villaggio B, Gianiorio F, Traverso P, et al. Testosterone promotes apoptotic damage in human renal tubular cells. Kidney Int. 2004;65(4):1252-61. doi:10.1111/j.1523-1755.2004.00497.x

5.        Casimir GJ, Lefèvre N, Corazza F, Duchateau J, Chamekh M. The acid–base balance and gender in Inflammation: a mini-review. Front Immunol. 2018;9:475. doi:10.3389/fimmu.2018.00475

6.        Gao Z, Wang Z, Zhu H, Yuan X, Sun M, Wang J, et al. Hyperinsulinemia contributes to impaired-glucose-tolerance-induced renal injury via mir-7977/SIRT3 signaling. Ther Adv Chronic Dis. 2020;11:2040622320916008. doi:10.1177/204062232091600              

7.        Uduagbamen PK, Ogunkoya JO, Alalade BA, Oyelese AT, Nwogbe IC, Eigbe SO, et al. Chronic Kidney Disease: Socioeconomic Impact. Findings from a Two Center Study in Southwestern Nigeria. IJHSR. 2021;11(10):336-47.

8.        Jafar TH, Schmid CH, Stark PC, Toto R, Remuzzi G, Ruggenenti P, et al. The rate of progression of renal disease may not be slower in women compared with men: a patient-level meta-analysis. Nephrol Dialy Transplant. 2003;18(10):2047-53.

9.        Li J, Hatano R, Xu S, Wan L, Yang L, Weinstein AM, et al. Gender difference in kidney electrolyte transport. I. Role of AT1a receptor in thiazide-sensitive Na+-Cl− cotransporter activity and expression in male and female mice. Am J Physiol-Renal Physiol. 2017;313(2):F505-13. doi:10.1152/ajprenal.00087.2017

10.      Yang CH, Moi SH, Chuang LY, Chen JB. Higher-order clinical risk factor interaction analysis for overall mortality in maintenance hemodialysis patients. Ther Adv Chronic Dis. 2020;11:2040622320949060. doi:10.1177/2040622320949060

11.      Graziani M, Nisticò R. Gender differences in pharmacokinetics and pharmacodynamics of methadone substitution therapy. Front Pharmacol. 2015;6:122. doi:10.3389/fphar.2015.00122

12.      Raphael KL, Murphy RA, Shlipak MG, Satterfield S, Huston HK, Sebastian A, et al. Bicarbonate Concentration, Acid-Base Status, and Mortality in the Health, Aging, and Body Composition Study. Clin J Am Soc Nephrol. 2016;11(2):308-16.

13.      Hansen SI, Petersen PH, Lund F, Fraser CG, Sölétormos G.  Gender-partitioned patient medians of serum albumin requested by general practitioners for the assessment of analytical stability. Clin Chem Lab Med. 2018;56(5):843-50. doi:10.1515/cclm-2017-0771

14.      National Kidney Foundation. KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 update. Am J Kidney Dis. 2012;60(5):850-86.

15.      Levey AS, Stevens LA, Schmid CH, Zhang Y, Castro III AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604-12. doi:10.7326/0003-4819-150-9-200905050-00006

16.      Hosmer DW, Lameshow S. Applied Logistic Regression. 2nd ed. Wiley: New York N.Y.; 2000. p. 95.

17.      Hermida RC, Ayala DE, Fernandez JR, Mojon A, Smolensky MH. Hypertension: New perspective on its definition and clinical management by bedtime therapy substantially reduces cardiovascular disease risk. Eur J Clin Investig. 2018;48(5):e12909. doi:10.1111/eci.12909

18.      Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015;6(6):850-67. doi:10.4239/wjd.v6.i6.850

19.      Lamb, EJ, MacKenzie F, Stevens PE. How should proteinuria be detected and measured?. Ann Clin Biochem. 2009;46(3):205-17. doi:10.1258/acb.2009.009007

20.      Medina-Rosas J, Gladman DD, Su J, Sabapathy A, Urowitz MB, Touma Z. Utility of untimed single urine protein/creatinine ratio as a substitute for 24-h proteinuria for assessment of proteinuria in systemic lupus erythematosus. Arthritis Res Ther. 2015;17(1):1-9.

21.      Cappellini MD, Motta I. Anemia in clinical practice—definition and classification: does hemoglobin change with aging?. InSeminars in hematology 2015 Oct 1 (Vol. 52, No. 4, pp. 261-269). WB Saunders. doi:10.1053/j.seminhematol.2015.07.006

22.      Weaving G, Batstone GF, Jones RG. Age and sex variation in serum albumin concentration: an observational study. Ann Clin Biochem. 2016;53(1):106-11. doi:10.1177/0004563215593561

23.      Tsai CW, Lin SY, Kuo CC, Huang CC. Serum uric acid and progression of kidney disease: a longitudinal analysis and mini-review. PloS one. 2017;12(1):e0170393.

24.      Unuigbe E. Funding renal care in Nigeria: a critical appraisal. Trop J Nephrol. 2006;1(1):33-8.

25.      Arogundade FA, Barsoum RS. CKD prevention in Sub-Saharan Africa: a call for governmental, nongovernmental, and community support. Am J Kidney Dis. 2008;51(3):515-23.

26.      Ponte B, Pruijm M, Marques-Vidal P, Martin PY, Burnier M, Paccaud F, et al. Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis. Nephrol Dial Transplant. 2013;28(9):2329-39. doi:10.1093/ndt/gft206

27.      Miller JA, Cherney DZ, Duncan JA, Lai V, Burns KD, Kennedy CR, et al. Gender differences in the renal response to renin-angiotensin system blockade. J Am Soc Nephrol. 2006;17(9):2554-60. doi:10.1681/ASN.2005101095

28.      Kaze AD, Ilori T, Jaar BG, Echouffo-Tcheugui JB. Burden of chronic kidney disease on the African continent: a systematic review and meta-analysis. BMC Nephrol. 2018;19(1):1-1. doi:10.1186/s12882-018-0930-5

29.      Farron MR, Kabeto MU, Levine DA, Wixom CR, Langa KM. Blood pressure and cognitive function among older adults in India. J Int Med Res. 2022;50(1):03000605211068720.

30.      Ulasi I. Gender bias in access to healthcare in Nigeria: a study of end-stage renal disease. Trop Doct. 2008;38(1):50-2.

31.      Sarfo FS, Mobula LM, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O, et al. Factors associated with uncontrolled blood pressure among Ghanaians: evidence from a multicenter hospital-based study. PloS one. 2018;13(3):e0193494.

32.      Iseki F. Gender differences in CKD. Kidney Int. 2008;74(4):415-7. doi:10.1038/ki2008.261

33.      Wu Y, Huang B, Zhang W, Farhan KAA, Ge S, Wang M, et al. The interaction analysis between advanced age and longer dialysis vintage on the survival of patients receiving maintenance hemodialysis. J Int Med Res. 2020;50(4):1-12. doi:10.1177/03000605221088557

34.      Uduagbamen PK, Salako BL, Hamzat MA, Kadiri S, Arogundade FA. Kidney Function in Frequent Users of Non-steroidal anti-inflammatory Drugs (NSAIDs). Open J Int Med. 2020;10(1):69-82.

35.      Ezzat M, Abd Razik B. Molecular Drug Design and Docking Study of Novel N-substituted Celecoxib Derivatives as Selective Cyclooxygenase-2 Inhibitors. Acta Pharm Sci. 2020;58(4).  doi:10.23893/1307-2080.APS.05823

36.      Akpan EE, Ekrikpo UE. Acute renal failure induced by Chinese herbal medication in Nigeria. Case Rep Med. 2015;2015. doi:10.1155/2015/150204

37.      Okaka EI, Okwuonu CG. Blood pressure variation and its correlates among patients undergoing hemodialysis for renal failure in Benin City, Nigeria. Ann Afr Med. 2017;16(2):65-9.

38.      Alemu H, Hailu W, Adane A. Prevalence of chronic kidney disease and associated factors among patients with diabetes in northwest Ethiopia: a hospital-based cross-sectional study. Curr Ther Res. 2020;92:100578.

39.      Tseng CK, Lin CH, Hsu HS, Ho CT, Huang HY, Liu CS, et al. In addition to malnutrition and renal function impairment, anemia is associated with hyponatremia in the elderly. Arch Gerontol Geriatr. 2012;55(1):77-81.

40.      Deepak P, Ehrenpreis ED. Lower body weight and female gender: Hyperphosphatemia risk factors after sodium phosphate preparations. World J Gastroenterol. 2011;17(21):2681-2. doi:10.3748/wjg.v17.i21.2681

41.      Barreto FC, Barreto DV, Massy ZA, Drüeke TB. Strategies for phosphate control in patients with CKD. Kidney Int Rep. 2019;4(8):1043-56.

42.      Onufrak SJ, Bellasi A, Cardarelli F, Vaccarino V, Muntner P, Shaw LJ, et al. Investigation of gender heterogeneity in the associations of serum phosphorus with incident coronary artery disease and all-cause mortality. Am J Epidemiol. 2009;169(1):67-77. doi:10.1093/aje/kwn285

43.      Veiras LC, Girardi AC, Curry J, Pei L, Ralph DL, Tran A, et al. Sexual dimorphic pattern of renal transporters and electrolyte homeostasis. J Am Soc Nephrol. 2017;28(12):3504-17. doi:10.1681/ASN.2017030295

44.      Ahmed S, Ahmad SA. Gender difference and relationship of insulin resistance with microalbuminuria type-2 diabetes. J Coll Physicians Surg Pak. 2010;20(1):26-32.

45.      Park JB, Kim SA, Sung KC, Kim JY. Gender-specific differences in the incidence of microalbuminuria in metabolic syndrome patients after treatment with fimasartan: The K-MetS study. Plos one. 2017;12(12):e0189342.


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