In chronic kidney disease (CKD), the impact of sex on long-term health-related quality of life is uncertain. For a study, researchers sought to examine how the evolution of health-related quality of life varies by gender in older men and women with severe CKD. The European Quality Study on Treatment in Advanced Chronic Kidney Disease was a European observational prospective cohort study of referred patients with CKD and an incident eGFR of 20 ml/min per 1.73 m^2 who were not on dialysis and were 65 years of age. Between April 2012 and September 2020, the 36-Item Short Form Survey was used to assess health-related quality of life at 3- to 6-month intervals, yielding Physical Component Summary and Mental Component Summary scores. Sex variations in health-related quality-of-life slope were investigated, and trajectories were modeled by sex using linear mixed models. 

In all, 1,421 patients completed 5,345 health-related quality-of-life assessments. Physical Component Summary (42) and Mental Component Summary (60) were significantly lower in women than in males at baseline (Physical Component Summary: 55; Mental Component Summary: 69; P<0.001). During follow-up, however, men’s Physical Component Summary and Mental Component Summary scores fell about twice as fast as women’s (Physical Component Summary: 2.5 per year; 95% CI, 1.8 to 3.1; Mental Component Summary: 2.7 per year; 95% CI, 2.0 to 3.4). (Physical Component Summary: 1.1 per year; 95% CI, 0.1 to 2.0; Mental Component Summary: 1.6 per year; 95% CI, 0.7 to 2.6). After controlling for significant confounders, such as eGFR reduction, the disparity was partially mitigated. Poorer Physical Component Summary and Mental Component Summary scores were linked with higher serum phosphate, lower hemoglobin, and the prevalence of preexisting diabetes in males, but to a lesser amount in women. Women had a worse health-related quality of life at baseline than men with advanced CKD, while males had a faster drop in health-related quality of life over time.

Reference:cjasn.asnjournals.org/content/17/2/205