Sex Differences in Biopsy-confirmed Diabetic Kidney Disease

Abstract Background: To investigate the association between sex differences and end-stage kidney disease (ESKD) in patients with biopsy-confirmed diabetic kidney disease (DKD). Method: We performed a retrospective cohort study. A total of 336 patients with biopsy-confirmed DKD who were followed up for at least 12 months were enrolled. Baseline clinical and pathological data were collected. ESKD was defined by an estimated glomerular filtration rate of <15 mL/min/1.73m 2 or initiation of renal replacement therapy. The association between sex differences and ESKD was assessed using the log-rank test and Cox regression. Result: There were 239 (71%) male and 97 (29%) female patients in our cohort. Female patients had higher systolic blood pressure, total cholesterol and low-density lipoprotein cholesterol levels, but relatively mild renal interstitial inflammation, compared with male. There was a lower proportion of female patients in the very high risk grade according to the chronic kidney disease categories. During a median follow-up time of 20 months, 101 (57.7%) men and 43 (44.3%) women entered into ESKD, with no significant difference by the log-rank test. Univariant and multivariant Cox regression further showed that sex difference was not associated with ESKD. Conclusion: Female patients had the higher systolic blood pressure, total cholesterol, LDL-C, but relatively mild renal interstitial inflammation, compared with male patients. However, there does not appear to be an association between sex difference and ESKD in our study.