Sex differences in chronic kidney disease prevalence in Asia: a systematic review and meta-analysis.

CKD albuminuria epidemiology gender systematic review

Journal

Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 26 10 2021
entrez: 6 6 2022
pubmed: 7 6 2022
medline: 7 6 2022
Statut: epublish

Résumé

Previous reports on the prevalence of chronic kidney disease (CKD) in Asia have suggested important sex disparities but have been inconsistent in nature. We sought to synthesize available sex-disaggregated CKD prevalence data in Asia to quantify sex disparities in the region. We systematically searched MEDLINE and Embase for observational studies involving ≥500 adults who reported sex-disaggregated CKD prevalence data in any of the 26 countries in East, Southeast and South Asia. For each study we calculated the female:male prevalence ratio (PR), with a ratio >1 indicating a higher female prevalence. For each country, log-transformed PRs were pooled using random effects meta-analysis. These were then combined using a fixed effects model, weighting by population size, to estimate a pooled PR for each of East, Southeast and South Asia and Asia overall. Sex-disaggregated data were available from 171 cohorts, spanning 15 countries and comprising 2 550 169 females and 2 595 299 males. Most studies (75.4%) came from East Asia (China, Taiwan, Japan and South Korea). Across Asia, CKD prevalence was higher in females {pooled prevalence 13.0% [95% confidence interval (CI) 11.3-14.9]} compared with males [pooled prevalence 12.1% (95% CI 10.3-14.1)], with a pooled PR of 1.07 (95% CI 0.99-1.17). Substantial heterogeneity was observed between countries. The pooled PRs for East, Southeast and South Asia were 1.11 (95% CI 1.02-1.21), 1.09 (0.88-1.36) and 1.03 (0.87-1.22), respectively. Current evidence suggests considerable between-country and -region heterogeneity in the female:male PR of CKD. However, there remains a large part of the region where data on sex-specific CKD prevalence are absent or limited. Country-level assessment of the differential burden of CKD in females and males is needed to define locally relevant policies that address the needs of both sexes.

Sections du résumé

Background UNASSIGNED
Previous reports on the prevalence of chronic kidney disease (CKD) in Asia have suggested important sex disparities but have been inconsistent in nature. We sought to synthesize available sex-disaggregated CKD prevalence data in Asia to quantify sex disparities in the region.
Methods UNASSIGNED
We systematically searched MEDLINE and Embase for observational studies involving ≥500 adults who reported sex-disaggregated CKD prevalence data in any of the 26 countries in East, Southeast and South Asia. For each study we calculated the female:male prevalence ratio (PR), with a ratio >1 indicating a higher female prevalence. For each country, log-transformed PRs were pooled using random effects meta-analysis. These were then combined using a fixed effects model, weighting by population size, to estimate a pooled PR for each of East, Southeast and South Asia and Asia overall.
Results UNASSIGNED
Sex-disaggregated data were available from 171 cohorts, spanning 15 countries and comprising 2 550 169 females and 2 595 299 males. Most studies (75.4%) came from East Asia (China, Taiwan, Japan and South Korea). Across Asia, CKD prevalence was higher in females {pooled prevalence 13.0% [95% confidence interval (CI) 11.3-14.9]} compared with males [pooled prevalence 12.1% (95% CI 10.3-14.1)], with a pooled PR of 1.07 (95% CI 0.99-1.17). Substantial heterogeneity was observed between countries. The pooled PRs for East, Southeast and South Asia were 1.11 (95% CI 1.02-1.21), 1.09 (0.88-1.36) and 1.03 (0.87-1.22), respectively.
Conclusions UNASSIGNED
Current evidence suggests considerable between-country and -region heterogeneity in the female:male PR of CKD. However, there remains a large part of the region where data on sex-specific CKD prevalence are absent or limited. Country-level assessment of the differential burden of CKD in females and males is needed to define locally relevant policies that address the needs of both sexes.

Identifiants

pubmed: 35664281
doi: 10.1093/ckj/sfac030
pii: sfac030
pmc: PMC9155252
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1144-1151

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.

Références

Glob Health Action. 2014 May 15;7:23248
pubmed: 24848651
J Am Soc Nephrol. 2015 Aug;26(8):2011-22
pubmed: 25766536
Heart. 2019 Nov;105(22):1701-1708
pubmed: 31371439
Kidney Int Suppl (2011). 2017 Oct;7(2):122-129
pubmed: 30675426
Am J Kidney Dis. 2016 Jun;67(6):851-60
pubmed: 26706255
Clin J Am Soc Nephrol. 2020 Feb 7;15(2):191-199
pubmed: 32001488
Nat Rev Nephrol. 2018 Mar;14(3):151-164
pubmed: 29355169
Ann Intern Med. 2006 Aug 15;145(4):247-54
pubmed: 16908915
PLoS One. 2016 Jul 06;11(7):e0158765
pubmed: 27383068
Atherosclerosis. 2015 Jul;241(1):205-7
pubmed: 26003338
Nephron. 2017;136(1):3-49
pubmed: 28319949
Nephrol Dial Transplant. 2020 Jul 1;35(7):1087-1090
pubmed: 32719854
Lancet. 2017 Oct 21;390(10105):1888-1917
pubmed: 28434650
Am J Kidney Dis. 2016 Jul;68(1):148-60
pubmed: 26943982
Lancet Glob Health. 2016 May;4(5):e307-19
pubmed: 27102194
BMJ Open. 2020 Dec 13;10(12):e040444
pubmed: 33318117
Kidney Int. 2015 Nov;88(5):950-7
pubmed: 26221752
Nephron. 2018;139(4):313-318
pubmed: 29791905
BMC Nephrol. 2017 Oct 13;18(1):311
pubmed: 29029600
BMJ. 2007 Oct 20;335(7624):806-8
pubmed: 17947786
Biol Sex Differ. 2020 Jan 3;11(1):1
pubmed: 31900228
Lancet. 2017 Sep 16;390(10100):1211-1259
pubmed: 28919117
Health Policy. 2004 Mar;67(3):329-43
pubmed: 15036820
Semin Nephrol. 2017 May;37(3):296-308
pubmed: 28532558
Nephrol Dial Transplant. 2020 Jul 1;35(7):1157-1163
pubmed: 32040151
Lancet. 2020 Feb 29;395(10225):709-733
pubmed: 32061315
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Kidney Int. 2015 Jul;88(1):178-85
pubmed: 25786102
Qual Life Res. 2019 Aug;28(8):2081-2090
pubmed: 30937731
Hypertension. 2016 Dec;68(6):1322-1327
pubmed: 27777357
Mayo Clin Proc. 2019 Jul;94(7):1339-1356
pubmed: 31272577
Kidney Int. 2011 Jul;80(1):17-28
pubmed: 21150873
Curr Diab Rep. 2018 Apr 18;18(6):33
pubmed: 29671082

Auteurs

Carinna Hockham (C)

George Institute for Global Health, School of Public Health, Imperial College London, London, UK.

Lexia Bao (L)

George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Anushree Tiku (A)

George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Sunil V Badve (SV)

George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Aminu K Bello (AK)

Division of Nephrology, University of Alberta, Edmonton, AB, Canada.

Meg J Jardine (MJ)

NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.

Vivekanand Jha (V)

George Institute for Global Health, School of Public Health, Imperial College London, London, UK.

Tadashi Toyama (T)

Department of Nephrology, Kanazawa University, Kanazawa, Japan.

Mark Woodward (M)

George Institute for Global Health, School of Public Health, Imperial College London, London, UK.

Min Jun (M)

George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Classifications MeSH