It is increasingly recognised that disparities exist between women and men in the epidemiology of chronic kidney disease (CKD), rates of progression and mortality but the scale and impact of these differences in real-world settings and their determinants are poorly understood. Although women appear to have higher burden of CKD than men, their life expectancy is significantly reduced in contrast to the general population. Uncertainty exists as to 1) whether these differences represent true biologic traits or differences in the quality of clinical care within health systems and 2) whether gender disparities in major complications of CKD can be explained by variation in baseline health or in care delivery.
To close these knowledge gaps, we will compare the health of women and men with CKD in longitudinal cohorts. We hypothesize that the excess morbidity and mortality in women over men develops during the progression of CKD and the emergence of metabolic complications, and is characterised by high rates of cardiovascular events and low rates of coronary interventions.
The Kidney Research Consortium at the University of Limerick (UL) will leverage the strengths of the Kidney Disease Surveillance System (KDSS) to create two contemporary cohorts of CKD in the Irish health system. We will examine the influence of gender on CKD burden, progression, and metabolic complications, and quantify its contribution to major clinical events. Comprehensive surveillance on demographic and time-varying clinical data recorded prior to major outcomes will be facilitated through core datasets that capture hospitalisation, dialysis and mortality. This programme of research will provide new insights into differences in major outcomes between men and women with CKD and serve to inform all Knowledge Users on key determinants. We anticipate that our findings will lead to new policy decisions and actionable initiatives to reduce health disparities and foster more Gender-Inclusive health planning.
