Eine chronische Niereninsuffizienz, auch in höherem Stadium, ist Patienten häufig unbekannt - aber warum wissen Frauen noch seltener von ihrer Erkrankung als Männer?

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Authors

  • Susanne Stolpe
  • Christian Scholz
  • Andreas Stang
  • Carsten Böger
  • Bettina Jung
  • Bernd Kowall
  • Cornelia Blume

Research Organisations

External Research Organisations

  • University of Duisburg-Essen
  • University of Cologne
  • Kliniken Südostbayern
  • Boston University (BU)
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Translated title of the contributionHigh patient unawareness for chronic kidney disease even in later stages - But why is it more frequent in women than in men?
Original languageGerman
Pages (from-to)E70-E81
JournalDeutsche Medizinische Wochenschrift
Volume147
Issue number17
Early online date4 Aug 2022
Publication statusPublished - 28 Aug 2022

Abstract

Introduction Chronic kidney failure (CKD) is as common as diabetes or coronary heart disease in a population aged 40 years and older. Although CKD increases the risk of secondary diseases or premature death, patients with CKD are often unaware of their disease. In a recent analysis of German data, unawareness CKD was higher in women than in men. Methods Baseline data from 2010 of 3,305 CKD patients from German cohort studies and registries were analyzed. Stage 1-4 CKD was defined by eGFR (estimated glomerular filtration rate) and albumin-creatinine ratio according to the KDIGO-guideline. Patient knowledge of CKD was coded according to self-report. The proportion of patients without knowledge of CKD and the sex-specific proportion difference (each with 95% confidence interval) were calculated according to CKD stages and additional comorbidities (diabetes, hypertension, anemia, and cardiovascular disease). In addition, the prevalence ratio (PR) for not knowing about CKD was estimated for women compared to men crude and adjusted for age and other risk factors. Results Women were less likely than men to know about their CKD in all subgroups studied by age, CKD stage, and comorbidities. The proportion difference for CKD awareness increased with higher CKD stage and was 21 percentage points (7.6; 34.6) at the expense of women in CKD stage 4. Among patients with CKD stage 3b and concomitant grade 2 hypertension, 61% of women versus 45% of men were unaware of their disease. The PR for CKD unawareness in women compared with men in the fully adjusted model increased from 1.08 (1.00; 1.16) in CKD stage 3a to 1.75 (1.14; 2.68) in CKD stage 4. Conclusion Despite the presence risk factors that necessitate monitoring of renal function, less than half of patients know they have CKD stage 3b or 4. Women are less likely to be aware of their CKD in all subgroups. Possible causes are gender-related differences in primary health care (gender bias) or in patient-doctor communication.

ASJC Scopus subject areas

Sustainable Development Goals

Cite this

Eine chronische Niereninsuffizienz, auch in höherem Stadium, ist Patienten häufig unbekannt - aber warum wissen Frauen noch seltener von ihrer Erkrankung als Männer? / Stolpe, Susanne; Scholz, Christian; Stang, Andreas et al.
In: Deutsche Medizinische Wochenschrift, Vol. 147, No. 17, 28.08.2022, p. E70-E81.

Research output: Contribution to journalArticleResearchpeer review

Stolpe S, Scholz C, Stang A, Böger C, Jung B, Kowall B et al. Eine chronische Niereninsuffizienz, auch in höherem Stadium, ist Patienten häufig unbekannt - aber warum wissen Frauen noch seltener von ihrer Erkrankung als Männer? Deutsche Medizinische Wochenschrift. 2022 Aug 28;147(17):E70-E81. Epub 2022 Aug 4. doi: 10.1055/a-1819-0870
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title = "Eine chronische Niereninsuffizienz, auch in h{\"o}herem Stadium, ist Patienten h{\"a}ufig unbekannt - aber warum wissen Frauen noch seltener von ihrer Erkrankung als M{\"a}nner?",
abstract = "Introduction Chronic kidney failure (CKD) is as common as diabetes or coronary heart disease in a population aged 40 years and older. Although CKD increases the risk of secondary diseases or premature death, patients with CKD are often unaware of their disease. In a recent analysis of German data, unawareness CKD was higher in women than in men. Methods Baseline data from 2010 of 3,305 CKD patients from German cohort studies and registries were analyzed. Stage 1-4 CKD was defined by eGFR (estimated glomerular filtration rate) and albumin-creatinine ratio according to the KDIGO-guideline. Patient knowledge of CKD was coded according to self-report. The proportion of patients without knowledge of CKD and the sex-specific proportion difference (each with 95% confidence interval) were calculated according to CKD stages and additional comorbidities (diabetes, hypertension, anemia, and cardiovascular disease). In addition, the prevalence ratio (PR) for not knowing about CKD was estimated for women compared to men crude and adjusted for age and other risk factors. Results Women were less likely than men to know about their CKD in all subgroups studied by age, CKD stage, and comorbidities. The proportion difference for CKD awareness increased with higher CKD stage and was 21 percentage points (7.6; 34.6) at the expense of women in CKD stage 4. Among patients with CKD stage 3b and concomitant grade 2 hypertension, 61% of women versus 45% of men were unaware of their disease. The PR for CKD unawareness in women compared with men in the fully adjusted model increased from 1.08 (1.00; 1.16) in CKD stage 3a to 1.75 (1.14; 2.68) in CKD stage 4. Conclusion Despite the presence risk factors that necessitate monitoring of renal function, less than half of patients know they have CKD stage 3b or 4. Women are less likely to be aware of their CKD in all subgroups. Possible causes are gender-related differences in primary health care (gender bias) or in patient-doctor communication.",
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author = "Susanne Stolpe and Christian Scholz and Andreas Stang and Carsten B{\"o}ger and Bettina Jung and Bernd Kowall and Cornelia Blume",
note = "Wir bedanken uns f{\"u}r die Unterst{\"u}tzung durch die KfH-Stiftung Pr{\"a}ventivmedizin, 63263 Neu-Isenburg.",
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Download

TY - JOUR

T1 - Eine chronische Niereninsuffizienz, auch in höherem Stadium, ist Patienten häufig unbekannt - aber warum wissen Frauen noch seltener von ihrer Erkrankung als Männer?

AU - Stolpe, Susanne

AU - Scholz, Christian

AU - Stang, Andreas

AU - Böger, Carsten

AU - Jung, Bettina

AU - Kowall, Bernd

AU - Blume, Cornelia

N1 - Wir bedanken uns für die Unterstützung durch die KfH-Stiftung Präventivmedizin, 63263 Neu-Isenburg.

PY - 2022/8/28

Y1 - 2022/8/28

N2 - Introduction Chronic kidney failure (CKD) is as common as diabetes or coronary heart disease in a population aged 40 years and older. Although CKD increases the risk of secondary diseases or premature death, patients with CKD are often unaware of their disease. In a recent analysis of German data, unawareness CKD was higher in women than in men. Methods Baseline data from 2010 of 3,305 CKD patients from German cohort studies and registries were analyzed. Stage 1-4 CKD was defined by eGFR (estimated glomerular filtration rate) and albumin-creatinine ratio according to the KDIGO-guideline. Patient knowledge of CKD was coded according to self-report. The proportion of patients without knowledge of CKD and the sex-specific proportion difference (each with 95% confidence interval) were calculated according to CKD stages and additional comorbidities (diabetes, hypertension, anemia, and cardiovascular disease). In addition, the prevalence ratio (PR) for not knowing about CKD was estimated for women compared to men crude and adjusted for age and other risk factors. Results Women were less likely than men to know about their CKD in all subgroups studied by age, CKD stage, and comorbidities. The proportion difference for CKD awareness increased with higher CKD stage and was 21 percentage points (7.6; 34.6) at the expense of women in CKD stage 4. Among patients with CKD stage 3b and concomitant grade 2 hypertension, 61% of women versus 45% of men were unaware of their disease. The PR for CKD unawareness in women compared with men in the fully adjusted model increased from 1.08 (1.00; 1.16) in CKD stage 3a to 1.75 (1.14; 2.68) in CKD stage 4. Conclusion Despite the presence risk factors that necessitate monitoring of renal function, less than half of patients know they have CKD stage 3b or 4. Women are less likely to be aware of their CKD in all subgroups. Possible causes are gender-related differences in primary health care (gender bias) or in patient-doctor communication.

AB - Introduction Chronic kidney failure (CKD) is as common as diabetes or coronary heart disease in a population aged 40 years and older. Although CKD increases the risk of secondary diseases or premature death, patients with CKD are often unaware of their disease. In a recent analysis of German data, unawareness CKD was higher in women than in men. Methods Baseline data from 2010 of 3,305 CKD patients from German cohort studies and registries were analyzed. Stage 1-4 CKD was defined by eGFR (estimated glomerular filtration rate) and albumin-creatinine ratio according to the KDIGO-guideline. Patient knowledge of CKD was coded according to self-report. The proportion of patients without knowledge of CKD and the sex-specific proportion difference (each with 95% confidence interval) were calculated according to CKD stages and additional comorbidities (diabetes, hypertension, anemia, and cardiovascular disease). In addition, the prevalence ratio (PR) for not knowing about CKD was estimated for women compared to men crude and adjusted for age and other risk factors. Results Women were less likely than men to know about their CKD in all subgroups studied by age, CKD stage, and comorbidities. The proportion difference for CKD awareness increased with higher CKD stage and was 21 percentage points (7.6; 34.6) at the expense of women in CKD stage 4. Among patients with CKD stage 3b and concomitant grade 2 hypertension, 61% of women versus 45% of men were unaware of their disease. The PR for CKD unawareness in women compared with men in the fully adjusted model increased from 1.08 (1.00; 1.16) in CKD stage 3a to 1.75 (1.14; 2.68) in CKD stage 4. Conclusion Despite the presence risk factors that necessitate monitoring of renal function, less than half of patients know they have CKD stage 3b or 4. Women are less likely to be aware of their CKD in all subgroups. Possible causes are gender-related differences in primary health care (gender bias) or in patient-doctor communication.

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KW - disease unawareness

KW - predictors of CKD unawareness

KW - sex differences

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DO - 10.1055/a-1819-0870

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JO - Deutsche Medizinische Wochenschrift

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