Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.

Chronic kidney disease (CKD) is a significant health challenge associated with high cardiovascular mortality risk. Historically, cardiovascular mortality risk has been found to higher in men than women in the general population. However, recent research has highlighted that this risk may be similar...

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Main Authors: Sultana Shajahan, Janaki Amin, Jacqueline K Phillips, Cara M Hildreth
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254554&type=printable
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author Sultana Shajahan
Janaki Amin
Jacqueline K Phillips
Cara M Hildreth
author_facet Sultana Shajahan
Janaki Amin
Jacqueline K Phillips
Cara M Hildreth
author_sort Sultana Shajahan
collection DOAJ
description Chronic kidney disease (CKD) is a significant health challenge associated with high cardiovascular mortality risk. Historically, cardiovascular mortality risk has been found to higher in men than women in the general population. However, recent research has highlighted that this risk may be similar or even higher in women than men in the CKD population. To address the inconclusive and inconsistent evidence regarding this relationship between sex and cardiovascular mortality within CKD patients, a systematic review and meta-analysis of articles published between January 2004 and October 2020 using PubMed/Medline, EMBASE, Scopus and Cochrane databases was performed. Forty-eight studies were included that reported cardiovascular mortality among adult men relative to women with 95% confidence intervals (CI) or provided sufficient data to calculate risk estimates (RE). Random effects meta-analysis of reported and calculated estimates revealed that male sex was associated with elevated cardiovascular mortality in CKD patients (RE 1.13, CI 1.03-1.25). Subsequent subgroup analyses indicated higher risk in men in studies based in the USA and in men receiving haemodialysis or with non-dialysis-dependent CKD. Though men showed overall higher cardiovascular mortality risk than women, the increased risk was marginal, and appropriate risk awareness is necessary for both sexes with CKD. Further research is needed to understand the impact of treatment modality and geographical distribution on sex differences in cardiovascular mortality in CKD.
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spelling doaj-art-e7b5e040da284eca984c1743d185af5f2025-08-20T02:54:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01167e025455410.1371/journal.pone.0254554Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.Sultana ShajahanJanaki AminJacqueline K PhillipsCara M HildrethChronic kidney disease (CKD) is a significant health challenge associated with high cardiovascular mortality risk. Historically, cardiovascular mortality risk has been found to higher in men than women in the general population. However, recent research has highlighted that this risk may be similar or even higher in women than men in the CKD population. To address the inconclusive and inconsistent evidence regarding this relationship between sex and cardiovascular mortality within CKD patients, a systematic review and meta-analysis of articles published between January 2004 and October 2020 using PubMed/Medline, EMBASE, Scopus and Cochrane databases was performed. Forty-eight studies were included that reported cardiovascular mortality among adult men relative to women with 95% confidence intervals (CI) or provided sufficient data to calculate risk estimates (RE). Random effects meta-analysis of reported and calculated estimates revealed that male sex was associated with elevated cardiovascular mortality in CKD patients (RE 1.13, CI 1.03-1.25). Subsequent subgroup analyses indicated higher risk in men in studies based in the USA and in men receiving haemodialysis or with non-dialysis-dependent CKD. Though men showed overall higher cardiovascular mortality risk than women, the increased risk was marginal, and appropriate risk awareness is necessary for both sexes with CKD. Further research is needed to understand the impact of treatment modality and geographical distribution on sex differences in cardiovascular mortality in CKD.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254554&type=printable
spellingShingle Sultana Shajahan
Janaki Amin
Jacqueline K Phillips
Cara M Hildreth
Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
PLoS ONE
title Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
title_full Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
title_fullStr Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
title_full_unstemmed Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
title_short Relationship between sex and cardiovascular mortality in chronic kidney disease: A systematic review and meta-analysis.
title_sort relationship between sex and cardiovascular mortality in chronic kidney disease a systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0254554&type=printable
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