Sex differences in clinical outcomes in Japanese incident dialysis patients: a prospective observational multicenter study

Kozaki, Yohei; Morinaga, Takatoshi; Fukatsu, Atsushi; Ito, Takeshi; Ishimoto, Takuji; Kosugi, Tomoki; Inaguma, Daijo; Tamai, Hirofumi; Maruyama, Shoichi

doi:10.1007/s10157-021-02168-8

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…Of note, life-satisfaction scores were higher in female, non-diabetic patients, and working patients. Female, non-diabetic and working people tend to have a good prognosis than male, diabetic and non-working people [14,15]. Physical condition can affect mental status.…”

Section: Discussionmentioning

confidence: 99%

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients receiving hemodialysis

Kondo

Nagai

Shima

et al. 2022

Preprint

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Objective: A questionnaire suggestive of patients’ health status is needed to assess their quality of life and improve their self-management skills. It is a descriptive, cross-sectional and multicenter study. The aim of this study was to assess the life-satisfaction and self-efficacy questionnaires verified in Japan which was more related to the biochemical and nutritional markers in patients receiving hemodialysis. A total of 196 outpatients receiving hemodialysis in four dialysis centers were included. The responses to the life-satisfaction and self-efficacy questionnaires were collected. Demographic and clinical characteristics of patients were obtained including life circumstances, in addition to nutritional indices such as normalized protein catabolism rate, creatinine generation rate and geriatric nutritional risk index. Results: Life-satisfaction scores were related to prognostic nutritional markers such as normalized protein catabolism rate and creatinine generation rate. Female sex and non-diabetic patients were more satisfied with the life undergoing hemodialysis. Elderly patients had higher self-efficacy scores, which was related to their life-satisfaction scores. However, self-efficacy scores were not associated with the biochemical and nutritional markers. This life-satisfaction questionnaire was simple and useful to assess the patient’s condition.

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Section: Discussionmentioning

confidence: 99%

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients receiving hemodialysis

Kondo

Nagai

Shima

et al. 2022

Preprint

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“…In a Japanese study [ 42 ], women on dialysis had a lower risk of all-cause death than men (19.9% vs 28.6%, P < 0.001 and HR: 0.70, 95% CI 0.54–0.90), with no differences in CV death (8.6 vs 10.9%, P = 0.177). In patients without CVD, female sex was a strong independent protective risk factor for all-cause mortality (HR 0.46, 95% CI: 0.30–0.70) while this advantage was lost for patients with CVD (HR 0.92, 95% CI: 0.67–1.24).…”

Section: Sex Disparities In Mortality In Men and Women With Ckdmentioning

confidence: 99%

Sex disparities in mortality and cardiovascular outcomes in chronic kidney disease

Balafa,

Fernandez-Fernandez,

Ortiz

et al. 2024

Clinical Kidney Journal

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Sex (biologically determined) and gender (socially constructed) modulate manifestations and prognosis of a vast number of diseases, including cardiovascular disease (CVD) and chronic kidney disease (CKD). CVD remains the leading cause of death in CKD patients. Population-based studies indicate that women present a higher prevalence of CKD and experience less CVD than men in all CKD stages, although this is not as clear in patients on dialysis or transplantation. When compared to the general population of the same sex, CKD has a more negative impact on women on kidney replacement therapy. European women on dialysis or recipients of kidney transplants have life expectancy up to 44.8 and 19.8 years lower, respectively, than their counterparts of similar age in the general population. For men, these figures stand at 37.1 and 16.5 years, representing a 21% to 20% difference, respectively. Hormonal, genetic, societal, and cultural influences may contribute to these sex-based disparities. To gain a more comprehensive understanding of these differences and their implications for patient care, well-designed clinical trials that involve a larger representation of women and focus on sex-related variables are urgently needed. This narrative review emphasizes the importance of acknowledging the epidemiology and prognosis of sex disparities in CVD among CKD patients. Such insights can guide research into the underlying pathophysiological mechanisms, leading to optimized treatment strategies and ultimately, improved clinical outcomes.

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“…Items such as renal function deterioration over time and mortality rate for each renal function were described in existing studies (Supplementary Table ). 24,26,41,42 Sensitivity Analyses Several sensitivity analyses were performed to ensure the robustness of this study. A one-way deterministic sensitivity analysis was performed to evaluate the effects of QOL and cost parameters, and the results were summarized in a tornado diagram.…”

Section: Scenario Analysesmentioning

confidence: 99%

Cost-Effectiveness of Dapagliflozin for Chronic Kidney Disease in Japan

Kodera

Morita

Nishi

et al. 2022

Circ J

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confirmed in a meta-analysis that included subanalyses of randomized, controlled trials of SGLT2 inhibitors in patients with diabetes. 11 Prescribing SGLT2 inhibitors to patients with CKD may be useful in preventing HF, but the number of patients with CKD is extremely large. In Japan approximately 8 million patients have CKD stage 3a and 1 million have CKD stage 3b, and prescribing SGLT2 inhibitors to all CKD patients may increase medical costs. 12 The rapid increase in medical expenses has become a social problem in Japan. Since 2019, cost-effective analyses, which provide a guide to the effective use of limited medical resources, have been incorporated into the Japanese medical administration system. Studies have been performed on the cost-effectiveness of SGLT2 inhibitors for diabetes, 13-17 and some have also investigated the costeffectiveness of SGLT2 inhibitors for HF. 18-20 Although there have been cost-effectiveness studies on SGLT2 inhibitors for CKD with and without diabetes mellitus in various countries, none has examined the cost-effectiveness of SGLT2 inhibitors for CKD in Japan. [21][22][23] The frequency of cardiovascular and renal events differs between the USA, Asian countries and Japan, and the medical systems also I n recent years, the number of patients with heart failure (HF) has rapidly increased in Japan as the number of older people has increased, and is termed a "heart failure pandemic". 1 Chronic kidney disease (CKD) is an important risk factor for HF, 2 so its treatment should curb the increase in patients with HF.Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been reported to be useful for treating CKD, 3 although they were originally developed as drugs that lower blood glucose concentrations by inhibiting glucose reabsorption in the renal proximal tubule. 4 Many studies have shown that SGLT2 inhibitors not only improve glycemic control in patients with diabetes, but also suppress cardiovascular events in those patients. 5-9 Many renal protective effects of SGLT2 inhibitors in diabetic patients have been reported, 6,7,10 as well as efficacy for CKD. 3 The Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD) trial 3 was a randomized, controlled trial that examined the effectiveness of dapagliflozin, an SGLT2 inhibitor, for CKD, in the presence or absence of diabetes. It showed that dapagliflozin prevented HF and hemodialysis (HD), and improved the prognosis in patients with CKD. The efficacy of SGLT2 inhibitors for CKD was also

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Sex differences in clinical outcomes in Japanese incident dialysis patients: a prospective observational multicenter study

Cited by 5 publications

References 23 publications

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients receiving hemodialysis

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients receiving hemodialysis

Sex disparities in mortality and cardiovascular outcomes in chronic kidney disease

Cost-Effectiveness of Dapagliflozin for Chronic Kidney Disease in Japan

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