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- ISSN
- 1931-857x
- eISSN
- 1522-1466
- DOI
- 10.1152/ajprenal.00660.2020
- Publisher site
- See Article on Publisher Site
Abstract
Background Progression of kidney disease may differ between sexes in type 2 diabetes (T2D), with studies reporting slower decline in women. Glomerular hyperfiltration is a key factor driving kidney function decline. The current study aims to investigate the differences in kidney hemodynamic function between men and women with T2D.Methods A cross-sectional analysis of pooled data from three studies comparing kidney hemodynamic function between men and postmenopausal women with T2D without overt nephropathy. The outcome measures were GFR (inulin clearance), effective renal plasma flow (ERPF; para-aminohippurate clearance), filtration fraction (GFR/ERPF) and renal vascular resistance (RVR; mean arterial pressure/RBF). Glomerular hydraulic pressure (PGLO), afferent and efferent vascular resistance were estimated by Gomez-formulae. Sex differences were assessed with linear regression models adjusted for systolic blood pressure, glucose, use of renin-angiotensin-system blockers and body mass index.Results 101 men (age: 63[58-68] years; BMI 31.5±3.9 kg/m2; GFR 111±18 mL/min; HbA1c 7.4±0.7%) and 27 women (age: 66[62-69] years; BMI 30.9±4.5 kg/m2; GFR 97±11 mL/min; HbA1c 7.1±0.5%) were included. GFR was higher in men versus women (11.0 mL/min; [95%CI; 3.6;18.4]). Although statistically non-significant, PGLO trended higher in men (1.9 mmHg [95%CI; -0.1;4.0], while RVR (-0.012 mmHg/L/min [95%CI; -0.022;-0.002]) and afferent vascular resistance were lower (-361 dyne/sec/cm5 [95%CI;-801;78]).Conclusions In adults without overt nephropathy, GFR was higher in men compared to women. PGLO also trended to be higher in men. Both findings are possibly related to afferent vasodilation and suggest greater prevalence of hyperfiltration. This could contribute to accelerated GFR loss over time in men with T2D.
Journal
American Journal of Physiology-Renal Physiology – The American Physiological Society
Published: Jun 1, 2021