ERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands.
Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
Nat Rev Nephrol. 2024 Jan;20(1):7-20. doi: 10.1038/s41581-023-00784-z. Epub 2023 Nov 20.
Improved understanding of differences in kidney disease epidemiology, management and outcomes in men and women could help nephrologists to better meet the needs of their patients from a sex- and gender-specific perspective. Evidence of sex differences in the risk and outcomes of acute kidney injury is mixed and dependent on aetiology. Women have a higher prevalence of chronic kidney disease (CKD) stages 3-5 than men, whereas men have a higher prevalence of albuminuria and hence CKD stages 1-2. Men show a faster decline in kidney function, progress more frequently to kidney failure and have higher mortality and risk of cardiovascular disease than women. However, the protective effect of female sex is reduced with CKD progression. Women are less likely than men to be aware of, screened for and diagnosed with CKD, started on antiproteinuric medication and referred to nephrologist care. They also consistently report a poorer health-related quality of life and a higher symptom burden than men. Women experience greater barriers than men to access the waiting list for kidney transplantation, particularly with respect to older age and obesity. However, women also have longer survival than men after transplantation, which may partly explain the comparable prevalence of transplantation between the sexes.
提高对男性和女性肾脏病流行病学、管理和结局差异的认识，可以帮助肾病学家从性别和性别特定的角度更好地满足患者的需求。急性肾损伤风险和结局存在性别差异的证据是混杂的，并且取决于病因。女性患 3-5 期慢性肾脏病（CKD）的比例高于男性，而男性患白蛋白尿和 CKD 1-2 期的比例较高。男性的肾功能下降速度较快，更频繁地进展为肾衰竭，死亡率和心血管疾病风险高于女性。然而，随着 CKD 的进展，女性的保护作用会减弱。女性对 CKD 的知晓率、筛查率和诊断率均低于男性，开始使用蛋白尿药物治疗和转至肾病科治疗的比例也较低。她们报告的健康相关生活质量和症状负担也比男性差。与男性相比，女性在等待肾移植方面面临更大的障碍，特别是在年龄较大和肥胖方面。然而，女性在移植后也比男性的存活率更高，这可能部分解释了两性之间移植的患病率相当。
