Show simple item record

Sex and the Risk of Atheromatous and Nonatheromatous Cardiovascular Disease in CKD: Findings From the CKD-REIN Cohort Study

dc.rights.licenseopenen_US
dc.contributor.authorFAUCON, Anne-Laure
dc.contributor.authorLAMBERT, Oriane
dc.contributor.authorMASSY, Ziad
dc.contributor.authorDRÜEKE, Tilman B.
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
dc.contributor.authorCOMBE, Christian
dc.contributor.authorFOUQUE, Denis
dc.contributor.authorFRIMAT, Luc
dc.contributor.authorJACQUELINET, Christian
dc.contributor.authorLAVILLE, Maurice
dc.contributor.authorLIABEUF, Sophie
dc.contributor.authorPECOITS-FILHO, Roberto
dc.contributor.authorHAUGUEL-MOREAU, Marie
dc.contributor.authorMANSENCAL, Nicolas
dc.contributor.authorALENCAR DE PINHO, Natalia
dc.contributor.authorSTENGEL, Bénédicte
dc.contributor.authorCANNET, Dorothée
dc.contributor.authorHAMROUN, Aghiles
dc.contributor.authorHERPE, Yves-Edouard
dc.contributor.authorLANGE, Céline
dc.contributor.authorMETZGER, Marie
dc.contributor.authorMOREL, Pascal
dc.contributor.authorPASCAL, Christophe
dc.contributor.authorAZAR, Raymond
dc.contributor.authorBELENFANT, Xavier
dc.contributor.authorBESNIER, Dominique
dc.contributor.authorBOURDENX, Jean Philippe
dc.contributor.authorBURTEY, Stéphane
dc.contributor.authorCHAUVEAU, Dominique
dc.contributor.authorCHAZOT, Charles
dc.contributor.authorCHOUKROUN, Gabriel
dc.contributor.authorDELAHOUSSE, Michel
dc.contributor.authorDEROURE, Benjamin
dc.contributor.authorESSIG, Marie
dc.contributor.authorGLOWACKI, François
dc.contributor.authorHANNEDOUCHE, Thierry
dc.contributor.authorHOFFMANN, Maxime
dc.contributor.authorHOURMANT, Maryvonne
dc.contributor.authorJAMALI, Mohamed
dc.contributor.authorJUILLARD, Laurent
dc.contributor.authorKAMAR, Nassim
dc.contributor.authorKELLER, Adrien
dc.contributor.authorKLEIN, Alexandre
dc.contributor.authorKUENTZ, François
dc.contributor.authorLACRAZ, Adeline
dc.contributor.authorLAMBREY, Guy
dc.contributor.authorLANDRU, Isabelle
dc.contributor.authorLANG, Philippe
dc.contributor.authorLEBRUN, Gaetan
dc.contributor.authorLOBBEDEZ, Thierry
dc.contributor.authorMAGNANT, Eric
dc.contributor.authorMAILLIEZ, Sébastien
dc.contributor.authorMAISONNEUVE, Nathalie
dc.contributor.authorMARTIN, Séverine
dc.contributor.authorMOULIN, Bruno
dc.contributor.authorNOEL, Christian
dc.contributor.authorPANESCU, Viktor
dc.contributor.authorSEKHRI, Hacène
dc.contributor.authorSMATI, Mustafa
dc.contributor.authorTESTA, Angelo
dc.contributor.authorTHERVET, Eric
dc.contributor.authorURENA, Pablo
dc.contributor.authorVELA, Carlos
dc.contributor.authorZAOUI, Philippe
dc.date.accessioned2025-03-21T14:25:41Z
dc.date.available2025-03-21T14:25:41Z
dc.date.issued2024
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/205633
dc.description.abstractEnRationale & Objective: Sex differences in cardiovascular disease (CVD) are well established, but whether chronic kidney disease (CKD) modifies these risk differences and whether they differ between atheromatous CVD (ACVD) and nonatheromatous CVD (NACVD) is unknown. Assessing this interaction was the principal goal of this study. Study Design: Prospective cohort study. Setting & Participants: Adults enrolled in the CKD-REIN (CKD-Renal Epidemiology and Information Network) cohort, a nationally representative sample of 40 nephrology clinics in France, from 2013 to 2020. Exposure: Sex. Outcomes: Fatal and nonfatal composite ACVD events (ischemic coronary, cerebral, and peripheral artery disease) and composite NACVD events (heart failure, hemorrhagic stroke, and arrhythmias). Analytical Approach: Multivariable cause-specific Cox proportional hazards models. Results: 1,044 women and 1,976 men with moderate to severe CKD (median age, 67 vs 69 y; mean estimated glomerular filtration rate [eGFR], 32 ± 12 vs 33 ± 12 mL/min/1.73 m2) were studied. During a median follow-up of 5.0 (IQR, 4.8-5.2) years, the ACVD rate (per 100 patient-years) was significantly lower in women than in men, at 2.1 (95% CI, 1.6-2.5) versus 3.6 (3.2-4.0; P < 0.01), whereas the NACVD rate was not, at 5.7 (5.0-6.5) versus 6.4 (5.8-7.0; P = 0.55). NACVD had a steeper relationship with eGFR than did ACVD. There was an interaction (P < 0.01) between sex and baseline eGFR and the ACVD hazard: the adjusted HR for women versus men was 0.42 (0.25-0.71) at 45 mL/min/1.73 m2 and gradually attenuated at lower levels of eGFR, reaching 1.00 (0.62-1.63) at 16 mL/min/1.73 m2. In contrast, the NACVD hazard did not differ between sexes across the eGFR range studied. Limitations: Cardiovascular biomarkers and sex hormones were not assessed. Conclusions: This study shows how the lower risk of ACVD among women versus men attenuates fully with kidney disease progression. The equal risk of NACVD between sexes across CKD stages and its steeper association with eGFR suggest an important contribution of CKD to the development of this CVD type. Plain-Language Summary: Sex differences in the risks of atheromatous and nonatheromatous cardiovascular disease (CVD) are well established in the general population. If or how chronic kidney disease (CKD) might modify these risks is unknown. In this large cohort of 3,010 patients with CKD, women had a lower risk than men of atheromatous CVDs such as coronary artery disease or stroke when they were at an early stage of CKD. This advantage, partly due to women's better cardiovascular risk profile, tended to attenuate as CKD progressed to kidney failure. In contrast, the risk of nonatheromatous CVDs such as heart failure for women with CKD appeared similar to that of men with CKD at all kidney function levels. © 2024 National Kidney Foundation, Inc.
dc.language.isoENen_US
dc.subject.ensex
dc.subject.enchronic kidney disease
dc.subject.encardiovascular disease
dc.subject.enatherosclerosis
dc.subject.enheart failure
dc.subject.enatrial fibrillation
dc.title.enSex and the Risk of Atheromatous and Nonatheromatous Cardiovascular Disease in CKD: Findings From the CKD-REIN Cohort Study
dc.typeArticle de revueen_US
dc.identifier.doi10.1053/j.ajkd.2024.04.013en_US
dc.subject.halSciences du Vivant [q-bio]en_US
bordeaux.journalAmerican Journal of Kidney Diseasesen_US
bordeaux.page546 – 556en_US
bordeaux.volume84en_US
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026en_US
bordeaux.issue5en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCHU de Bordeauxen_US
bordeaux.institutionInstitut Bergoniéen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=American%20Journal%20of%20Kidney%20Diseases&amp;rft.date=2024&amp;rft.volume=84&amp;rft.issue=5&amp;rft.spage=546%20%E2%80%93%20556&amp;rft.epage=546%20%E2%80%93%20556&amp;rft.au=FAUCON,%20Anne-Laure&amp;LAMBERT,%20Oriane&amp;MASSY,%20Ziad&amp;DR%C3%9CEKE,%20Tilman%20B.&amp;COMBE,%20Christian&amp;rft.genre=article


Files in this item

FilesSizeFormatView

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record