Miss RUI DU1,2, JEFFREY T HA1,3, HANNAH WALLACE1, HIDDO J L HEERSPINK1,4, SRADHA S KOTWAL1,5
1The George Institute for Global Health, Sydney, Australia, 2Tsinghua University, Beijing, China, 3Wollongong Hospital, Wollongong, Australia, 4University Medical Center Groningen, Groningen, Netherlands, 5Prince of Wales Hospital, Sydney, Australia
Biography:
Rui Du is an MD candidate at Tsinghua University, currently working as a visiting student in the Renal and Metabolic Division at the George Institute for Global Health Australia. Under the mentorship of A/Prof Sradha Kotwal, Rui has actively contributed to clinical research, including the Global Kidney Patient Trials Network (GKPTN) and the Chronic kidney disease Adaptive Platform Trial Investigating Various Agents for Therapeutic Effect (CAPTIVATE) studies, focusing on implementing novel clinical trials and improving outcomes for people with kidney disease.
Aim:
This study aims to assess sex disparities in the receipt of guideline-based medications in a global CKD cohort.
Background:
Chronic kidney disease (CKD) is a growing global health burden, affecting 10% of the adult population worldwide. Recent studies demonstrate sex disparities in CKD prevalence, incidence, and outcomes, yet evidence on sex-related differences in therapeutic management remains limited.
Methods:
Data for participants recruited into the Global Kidney Patient Trials Network (GKPTN), a multi-centre observational cohort recruiting CKD patients since May 2020 was reviewed. Patients with valid sex were included and were excluded if with estimated glomerular filtration rate (eGFR)<20mL/min/1.73m2. Outcomes were the receipt of guideline-based therapies, including renin-angiotensin system inhibitor (RASi), sodium glucose co-transporter-2 inhibitor (SGLT2i) and/or any diuretics. Multivariable logistic models adjusted for age, race, body mass index (BMI), presence of cardiovascular disease (CVD) and diabetes, CKD etiology and prognosis risk, examined associations between sex and the likelihood of receiving therapies, as well as the interaction between sex and other risk factors (age, KDIGO-risk categories, and comorbid conditions).
Results:
Of 5076 participants, 3988 with CKD met criteria for this study (mean age 62.6y, 40.5% female). Compared with males, females had lower odds of receiving RASi (adjusted OR=0.712, 95%CI 0.605-0.839; p<0.001) and SGLT2i (aOR=0.734, 95%CI 0.593-0.907; p=0.004), with no significant difference in the use of diuretics. There were no significant interactions between sex and other risk factors assessed, indicating that sex-related disparities in the receipt of RASi and SGLT2i remained consistent across risk factor subgroups.
Conclusions:
In this large global CKD cohort, females were less likely to receive guideline-based therapies than males. This highlights potential inequities in treatment allocation globally for women with CKD.
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