Insights on Nephrology: Key Abstracts From Kidney Week 2022

The American Society of Nephrology’s Kidney Week 2022 explored the latest diagnostic and therapeutic developments in nephrology. Learn more about the latest in kidney care from a collection of abstracts presented at the conference.

Does a CKD Patient’s Sex Impact Their CVD Risk? An Update from Kidney Week 2022

Females in the general population have a lower risk for cardiovascular disease (CVD) when compared to males. But is this sex-specific risk pattern also seen in patients with chronic kidney disease (CKD)? Little was known about this potential link—until now.

A poster featured at the 2022 American Society of Nephrology (ASN) Annual Meeting broke down the findings of a recent study that utilized results from patients with and without CKD who participated in the National Health and Examination Survey to determine if a sex-specific risk of CVD exists among patients with CKD.

The odds ratio for self-reported CVD and the atherosclerotic cardiovascular disease (ASCVD) risk score were the two main endpoints evaluated in this study using multivariable logistic regression models.

The study included over 40,000 adults with and without CKD. And since the non-CKD and CKD subgroups both included patients between the ages of 18 and 75, the adults in the non-CKD subgroup were further divided into those who were 55 years and older; this enabled the researchers to better match the mean age between the two subgroups.

In terms of results, the researchers found that females without CKD had lower odds of developing CVD than males, but no sex difference was identified in the CKD subgroup. When it came to the ASCVD endpoint, females with CKD had higher odds of ranking intermediate-high and low-borderline on the ASCVD risk score compared to females without CKD, and no difference in the ASCVD risk score was observed between males with and without CKD.

These findings suggest that CKD negates the cardiovascular protection that’s typically seen among females without CKD and that CKD may be a stronger risk factor for CVD in females than males.

Updates on Discrete Choice Experiment for Patients with Dialysis End-of-Life Care

Some patients with kidney failure struggle to know their personal wishes and priorities as they go through the different stages of this disease, including up to the time of the end of their life. A recent study was conducted to help close the knowledge gap for dialysis patients by identifying factors that are important to them.

The study was an online survey that evaluated end-of-life care in terms of importance by the degree of pain management, how often patients were hospitalized, and the place of death. It was comprised of 796 patients, of which 2.2 percent were being treated with dialysis at home, and 97.8 percent were receiving in-center dialysis.

The baseline characteristics included:

• Average patients were 54 years old
• 40 percent of patients were women
• 37 percent white
• 35 percent black
• 16 percent Hispanic
• Five percent Asian

70 percent of patients reported being on dialysis for one to seven years. Of the 70 percent, 49 percent said their health was average compared to other dialysis patients, while 33 percent rated their health better.

The results of the online study showed that the most important attribute of quality of care to end-of-life patients was well-managed pain. They were 3.7 times more likely to choose this over poor pain management. There was a 1.5 greater chance that patients would rather choose to die at home versus in the hospital. And the least important factor for patients was the frequency of hospital visits.