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On 25 February, Taryn Vosters will defend her PhD thesis, offering new insights into chronic kidney disease (CKD) and its complex relationship with sex, gender, and ethnicity. Her work highlights the urgent need for more targeted prevention and detection strategies to address disparities in CKD outcomes.

Prevalence Patterns Differ

Studies show that women generally have a higher prevalence of CKD than men, but this varies by ethnicity. For example, Dutch men have slightly higher CKD rates than Dutch women, while African Surinamese women are more affected than their male counterparts. Traditional risk factors like hypertension and diabetes contribute more to CKD in men, whereas obesity plays a larger role in women. "Our research demonstrates that the differences in CKD prevalence between women and men cannot be fully explained by traditional risk factors," says Taryn Vosters.

Progression and Risk Factors

The thesis found that CKD progression is often faster in men, but patterns differ across ethnic groups. African Surinamese and Dutch women experienced greater kidney function decline than men, while the opposite was true for South Asian Surinamese and Moroccan groups. "Sex differences in kidney function decline are not simply due to common risk factors," Vosters explains.

Detection Gaps

Current CKD screening guidelines, which focus on the presence of hypertension, diabetes, and cardiovascular disease, tend to identify men more effectively than women. Adding criteria like obesity or socioeconomic status did not improve detection rates for either sex. "Our findings highlight the need to evaluate new factors to improve CKD screening, especially for women," Vosters notes.

Gender-Related Influences

Gender roles and employment status also impact CKD risk. Women working part-time and doing little housework had higher CKD risk, while men with equal household financial contribution or unemployment were more affected. "These associations are not explained by traditional risk factors, suggesting other influences are at play," says Vosters.

Shift Work Effects

Men working in shifts showed greater kidney function decline, while women were not similarly affected. "Men and women may be impacted differently by shift work, and sex-specific recommendations should be considered," Vosters recommends.

Early Menopause and CKD

Early menopause did not consistently affect kidney function overall, but was linked to faster kidney decline in African Surinamese and Moroccan women. "Early menopause may not impact all groups equally, and more research is needed," Vosters concludes.

Including diverse populations

The thesis underscores that CKD patterns differ by sex and ethnicity, and current detection methods may miss at-risk women. Social and gender-related factors also play a role, but further research is needed to understand these mechanisms. "We encourage future research to report findings by sex and include diverse populations to better address CKD disparities," says Taryn Vosters.