Sex and gender differences in chronic kidney disease and access to care around the globe

Sex Differences in CKD-Associated Mortality From 1990 to 2019: Data From the Global Burden of Disease Study

“…In a recently published review of sex and gender differences in access to kidney care around the globe, and with particular attention to Mexico and Central America, 17 the authors hypothesised that occupational factors, faster progression to kidney failure, lower compliance with treatment and lower use of health services in males together may J o u r n a l P r e -p r o o f explain their higher CKD mortality. This is likely compounded by the rising prevalence of diabetes and hypertension, which together account for more than 50% of CKD deaths, along with the presence of hotspots of CKD of unknown etiology (CKDu), which predominantly affects males of working age.…”

“…The sex disparity in the changes in CKD mortality that was observed in each of these countries is likely the result of a complex combination of gendered and social factors, including unequal access to medical care, kidney replacement therapy (KRT), and disease-halting treatment. 17 In Egypt, for example, 42% of patients receiving dialysis in 2020 were females, despite the prevalence of CKD (albeit all stages) being 20% higher among females. 4 , 18 However, given that this gender imbalance in KRT recipients is not unique to Egypt or the other countries listed, 17 other factors will also be at play and most likely relate to stark gender inequalities that exist.…”

“… 17 In Egypt, for example, 42% of patients receiving dialysis in 2020 were females, despite the prevalence of CKD (albeit all stages) being 20% higher among females. 4 , 18 However, given that this gender imbalance in KRT recipients is not unique to Egypt or the other countries listed, 17 other factors will also be at play and most likely relate to stark gender inequalities that exist. Indeed, with the exception of Malaysia, all of these countries ranked among the lowest 20 countries of the 153 included in the 2020 Global Gender Gap Index.…”

Potential Similarities in Sex Difference in Key Genes and Their Expression, Network, EQTL and Pathways between COVID-19 and Chronic Kidney Disease Based on Mouse Model

“…Studies on important genes in the pathological pathways of COVID-19 have shown a surprising coincidence with the important genes in chronic kidney disease (CKD) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. In particular, several key genes have been reported from pathological pathway of both diseases, such as angiotensin-converting enzyme 2 (ACE2), A disintegrin and metalloproteinase domain 17 (ADAM17), transmembrane serine protease 2 (TMPRSS2), and melanoma adhesion molecule (CD146/MCAM).…”

“…Evidently, it has been known that sex difference exists in CKD. For example, the proportion of women with predialysis CKD is higher than that of men; kidney function declines faster in men than women, and mortality is higher among men at all levels of predialysis CKD, in particular among old men [ 1 , 2 , 3 ]. While lifestyle and habits influence the sex difference of CKD, biological and genetic differences between men and women also play an important role.…”