Women face worse chronic kidney disease management in primary care

Women receive worse primary care-based chronic kidney disease (CKD) management than men, according to a research letter published in the Journal of the American Medical Association to coincide with the annual meeting of the Society of General Internal Medicine, held from May 15 to 18 in Boston.

Jorge A. Rodriguez, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted a retrospective analysis of adult patients with CKD receiving primary care at 15 practices using electronic health record data to examine sex disparities in guideline-based CKD management and new care processes. The cohort included 7,903 adults (59.7% women).

The researchers found that across most outcomes, women experienced worse care than men. Women were less likely to have any laboratory testing (adjusted odds ratio, 0.83); however, no significant differences were seen in cystatin C testing (1.1 versus 1.6%). Women were less likely than men to be prescribed a renal-angiotensin-aldosterone system inhibitor or a sodium-glucose cotransporter-2 inhibitor (adjusted odds ratios, 0.80 and 0.41, respectively). Compared with men, women were less likely to have controlled blood pressure (adjusted odds ratio, 0.82). Women were also less likely to see a nephrologist than men (adjusted odds ratio, 0.59).

“Though many differences were of small magnitude, the disparity deserves further examination,” the authors write. “These findings align with international studies showing that females are less likely to receive CKD disease monitoring, medication prescribing, and nephrology referral.”

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