Sex-Associated Biomarker Differences in CKD Progression and Mortality

KEY POINTS: A higher risk of kidney failure and mortality persisted in men with CKD, despite adjusting for sociodemographic, clinical, and treatment factors. Differences in biomarkers linked to CKD progression and cardiovascular stress were observed between men and women after adjusting for eGFR and urine albumin-to-creatinine ratio. When adjusting for the differences in the biomarkers, the excess risk of kidney failure and mortality seen in men was eliminated. BACKGROUND: Men with CKD experience worse outcomes than women, a difference not fully explained by comorbidities or sociocultural factors. We explored whether sex-based differences in biomarkers could account for this difference in risk. METHODS: Our study included 1680 male and 1204 female participants with non-dialysis-dependent CKD and 84 controls from National Unified Renal Translational Research Enterprise-CKD, a prospective multicenter cohort study. Twenty-one biomarkers relating to kidney injury and fibrosis, inflammation, and cardiovascular stress were measured. Outcomes were kidney failure (eGFR