The Association and Contribution of Gender-related Characteristics on Prevalent Chronic Kidney Disease in women and men in a multi-ethnic population

Abstract

Background: Differences in the prevalence of chronic kidney disease (CKD) between women and men have previously been reported. While biological explanation factors have been explored, research on sociocultural factors has been lacking. This paper investigates the influence that gender-related characteristics may have on the prevalence of CKD in women and men in a multi-ethnic population. Research question: To what extent do gender-related characteristics contribute to CKD stage 1-5 and 3-5 in women and men aged 18-70 years in a multi-ethnic population. It will be investigated (1) which (if any) categories of gender-related characteristics are associated with the prevalence of CKD in women and men in a multi-ethnic population. And (2) to what extent do these gender-related characteristics contribute to the burden of prevalent CKD. Methods: Cross-sectional analyses were performed on data from the Helius Study, across women and men and various ethnic groups. Poisson Regression was used to determine whether significant associations were present between CKD Outcomes (eGFR & ACR) and the gender-related variables 1) Time spent on Housework, 2) Primary Earner Status, 3) Employment Status, and 4) Occupational Segregation. Further Population Attributable Fractions were calculated to estimate the contribution of gender to prevalent CKD. Results: Associations were found for CKD 1-5 and doing high amounts of housework in women, as well as all categories of employment status. In men, being unemployed showed a significant association in both CKD Outcomes. Being the primary earner proved significantly higher prevalence in women and men and CKD. Associations were mostly consistent across ethnic groups. Estimated contributions ranged between 13-54% and were attenuated by potential mediators. Conclusion: The findings show that several gender-related characteristics are associated with CKD and that gender contributes to prevalent CKD in women and men in a multi-ethnic population. Further research should be conducted to determine target groups and develop precise interventions.