Differential Impact of Dyslipidemia on Chronic Kidney Disease between Men and Women

Dyslipidemia (DLD), defined as an imbalance of lipids in the blood, is proven to have a strong association with chronic kidney disease (CKD). CKD is more frequent in women than men, although men are more likely to progress to severe stages. Whether sex differences drive the effect of DLD on CKD severity remains unclear. In this study, the relationship between biological sex and CKD severity was investigated by parsing the public electronic health records of 491 CKD patients in Abu Dhabi. Sex-specific relative risks (RRs) were calculated using a history of DLD as a risk factor for severe CKD (stages 3 - 5). The RR was 2.98 (95% CI: 1.78 - 4.18) in women and 2.86 (95 CI%: 2.02 - 3.70) in men. Smoking was identified as a confounding variable because it has a higher incidence in men and a known negative impact on CKD. Thus, we validated the findings in a subsetted group excluding any patient with a history of smoking: the RR was 2.96 (95% CI: 1.76 - 4.16) in women and 2.61 (95% CI: 1.57 - 3.65) in men. These results indicate that, among CKD patients, women with DLD are more likely to progress to severe stages of CKD than men with DLD. The excess risk may be explained by notably higher rates of obesity in women and the idea that women have poorer adherence to DLD medications, although this is newly discovered evidence. Future studies are needed to investigate mechanisms behind this observed disparity.