Gender-associated features in diabetic kidney disease

Diabetic kidney disease (DKD) is the leading cause of end-stage renal failure. Evidence indicates gender differences in the progression of this disease. This study aimed to determine gender differences in prevalence and identify gender-associated risk factors contributing to the development of diabetic kidney disease in individuals with type 2 diabetes mellitus (T2DM). The cross-sectional study included 132 patients with T2DM ranging in age from 50 to 65 years. Subjects were stratified by sex (80 women and 52 men). Gender differences have been studied in relation to the incidence and prevalence of DKD, their phenotypes and clinical manifestations, and several risk factors that have different effects on both sexes. The outcome of clinical kidney function assessment showed that 70% subjects were diagnosed with DKD (71% of women and 67% of men). The study indicated an association between the duration of T2DM and urinary albumin levels, as well as between arterial hypertension and triglyceride levels, which are independent risk factors for DKD development. Notably, older women with T2DM have a higher prevalence of DKD than older men. The albuminuric component of DKD was more frequently observed in men. Additionally, men were more likely to have adverse risk factors, including dyslipidemia, lower high-density lipoprotein cholesterol, and glomerular filtration rate, which are factors involved in the mechanisms of DKD. In summary, the results indicate that: 1) women with type 2 diabetes mellitus are at a higher risk of developing a normoalbuminuric phenotype of diabetic kidney disease, while men are at a higher risk of developing an albuminuric phenotype of diabetic kidney disease leading to renal failure and end-stage renal disease; 2) gender differences are most noticeable among older adults and may have significant implications for the development of more effective diagnostic and treatment methods for diabetic kidney disease, tailored to individual needs.