(128) Sex-specific temporal trends in prevalence and incidence of chronic kidney disease: a Danish population-based cohort study

Background: The prevalence of chronic kidney disease (CKD) is known to vary substantially by age and sex, attributed in part to differences in underlying risk factors. Therefore, ageing populations, the rising prevalence of metabolic and cardiovascular diseases, along with other risk factors, shifts in the CKD awareness, and the introduction of new treatments aimed at preventing CKD and its progression, may affect sex-specific temporal trends in the prevalence and incidence of CKD. Understanding these changes is crucial as it may guide intervention strategies for screening and treatment of CKD. Therefore, there is a need for contemporary population-based data on sex-specific temporal trends in the prevalence and incidence of CKD.

Objectives: We aimed to examine sex-specific temporal trends in the prevalence and incidence of CKD from 2011 through 2021.

Methods: We conducted a population-based cohort study among adults residing in the North and Central Denmark Regions (population ~1.5 million in 2021), utilising routinely collected individual-level laboratory data. We identified individuals with prevalent or incident CKD stages G3-G5, using plasma creatinine data from all blood samples performed in outpatient hospital settings or in primary care.
We estimated annual sex-specific crude and age-standardised prevalence and incidence rates and tabulated clinical characteristics by calendar periods.

Results: While the crude prevalence of CKD increased from 2011 through 2021 regardless of sex, the standardised prevalence among females decreased from 84.5 per 1,000 individuals (95% confidence interval (CI): 83.9-85.1) to 75.6 (95% CI: 75.2-76.1), and it remained stable among males, ranging from 52.2 (95% CI: 51.7-52.7) to 52.3 (95% CI: 51.9-52.7).
During the 2011-2021 period, both the crude and standardised incidence rates of CKD exhibited similar patterns of overall decline. We observed a transient increase during 2011-2013, particularly in the standardised incidence rate among both females and males. This was followed by a decrease from 10.8 per 1,000 person-years in 2013 (95% CI: 10.5-11.0) to 6.7 in 2021 (95% CI: 6.6-6.9) among females and from 9.4 (95% CI: 9.2-9.7) to 6.4 (95% CI: 6.2-6.6) among males.
Throughout the 2011-2021 period, the prevalence and incidence of CKD remained higher among females than among males.

Conclusions: The prevalence and incidence of CKD has remained higher among females than among males from 2011 through 2021. While the crude prevalence increased during 2011-2021, the standardised prevalence decreased slightly among females and was stable among males, while incidence rates decreased considerably from 2013 and onwards regardless of sex.