Background
Previous reports on the prevalence of chronic kidney disease (CKD) in Asia have suggested important sex disparities but have been inconsistent in nature. We sought to synthesise available sex-disaggregated CKD prevalence data in Asia to quantify sex disparities in the region.
Methods
We systematically searched MEDLINE and EMBASE for observational studies involving ≥500 adults that reported sex-disaggregated CKD prevalence data in any of the 26 countries in East, Southeast, or South Asia. For each study, we calculated the female:male prevalence ratio (PR), with a ratio >1 indicating a higher female prevalence. For each country, log-transformed PRs were pooled using random effects meta-analysis. These were then combined using a fixed effect model, weighting by population size, to estimate a pooled PR for each of East, Southeast, and South Asia, and Asia overall.
Results
Sex-disaggregated data were available from 171 cohorts, spanning 15 countries, and comprising 2,550,169 females and 2,595,299 males. Most studies (75.4%) came from East Asia (China, Taiwan, Japan, and South Korea). Across Asia, CKD prevalence was higher in females (pooled prevalence 13.0% [95% CI 11.3-14.9%]) compared with males (pooled prevalence 12.1% [10.3-14.1%]), with a pooled PR of 1.07 (0.99-1.17). Substantial heterogeneity was observed between countries. The pooled PRs for East, Southeast, and South Asia were 1.11 (1.02-1.21), 1.09 (0.88-1.36,) and 1.03 (0.87-1.22), respectively.
Conclusions
Current evidence suggests considerable between-country and -region heterogeneity in the female:male PR of CKD. However, there remains a large part of the region where data on sex-specific CKD prevalence are absent or limited. Country-level assessment of the differential burden of CKD in females and males is needed to define locally relevant policies that address the needs of both sexes.
