Chronic Kidney Disease (CKD) can affect anyone regardless of their age, race or gender. However, CKD tends to affect women more than men, and approximately 195 million women worldwide suffer from Chronic Kidney Disease. This makes it the 8th leading cause of death for women, resulting in 600,000 deaths each year.
March 14 marks World Kidney Day, a day to raise awareness for kidney disease and the importance of kidney health. For 2019, World Kidney Day’s theme is “For Everyone Everywhere.” This campaign spotlights how kidney disease affects people from all over the world, particularly women from different countries. What is it about CKD that puts women at an increased risk, and does that automatically indicate the disease will progress more quickly for women as well? Recent studies have found some unexpected yet positive results.
What is Chronic Kidney Disease?
Kidneys are a vital part of the body. They are responsible for filtering waste and excess fluids from the blood, which are then expelled through urine. Chronic kidney disease, which is also known as chronic kidney failure, is the gradual failure of kidney function. When the kidneys are no longer able to filter properly, fluid, electrolytes and waste can develop to dangerous levels in the body.
Symptoms of CKD
Chronic kidney disease can appear to have little to no symptoms in its early stages. In fact, CKD may not show apparent symptoms until the kidney has been significantly impaired. Since the disease slowly damages the kidneys, symptoms will progress slowly and may vary from person to person. Additionally, symptoms of CKD are often non-specific and can be caused by other urologic conditions. Symptoms of CKD include:
- Muscle twitches and cramps
- Swelling of feet and ankles
- Persistent itching
- Chest pain
- Shortness of breath
- High blood pressure
- Nausea or vomiting
- Fatigue and weakness
- Frequent urination
Common Risk Factors
CKD can be caused by a variety of conditions affecting the blood, urine or kidneys themselves. These include high blood pressure, type 1 or 2 diabetes, inflammation or infection of the kidneys or surrounding areas, kidney stones, enlarged prostate, cancers of the urinary tract, or polycystic kidney disease. Smoking, obesity, old age, and a family history of the disease can also increase your risk for developing CKD.
Why are Women at an Increased Risk?
According to the Center of Disease Control (CDC), 18 percent of the women are diagnosed with CKD while 13 percent of men are diagnosed. This is because women experience risk factors that are unique to females. These specific risk factors combined with the lowered access to decent healthcare in developing countries, put women at a higher risk of developing CKD.
Pregnancy can put women at a higher risk for CKD in a number of ways. Especially in developing countries, women tend to have children at a younger age, and younger mothers are often a higher risk of preeclampsia. Preeclampsia, a complication of pregnancy caused by placental insufficiency, can lead to acute kidney injury (AKI). AKI can then develop into CKD and even end-stage renal disease later in life. Preeclampsia also increases the baby’s risk for developing CKD, diabetes and cardiovascular disease later in life.
Pregnant or not, women still have far more UTIs than men. Certain birth control methods, changes in hormones and shorter urethras put women at a higher risk of developing a urinary tract infection. Prolonged UTIs are known to cause CKD due to the extra bacteria the kidneys must filter. Pyelonephritis, or kidney infection, is a type of UTI that has moved from the bladder into the kidney causing serious complications.
Autoimmune disorders such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic scleroderma (SS) make it difficult for the kidneys to fight off an infection. SLE turns the body’s own immune system against it, and it primarily affects women more than men. Kidney damage caused by SLE is known as Lupus Nephritis (LN).
Studies Show Slower CKD Progression
While women may be at a higher risk of contracting CKD, recent studies show they are actually at a lower risk of CKD progression than men. This 2018 study focused on 3,838 men and women who had been diagnosed with mild-to-moderate chronic kidney disease. When analyzing the progression of the disease, researchers discovered that women have a 28 percent decreased risk of end-stage renal disease, and a 44 percent lower risk of death compared to men.
While this study did shed light on how CKD progresses differently in men and women, researchers stated that more work needs to be done due to its limitations. One limitation referenced in the study was the lack of awareness of CKD among women. Women are less likely to be screened for CKD, which can lead to skewed results in statistics. Additionally, the lack of awareness could lead to CKD going undiagnosed until the condition has reached its late stages.
Importance of Routine Screening
The primary treatment for kidney disease involves slowing the progression of the kidney damage by managing the underlying cause. Later stages of CKD are often treated with dialysis (artificial filtering) or a kidney transplant. Without treatment, CKD can lead to end-stage kidney failure, which is fatal. Because CKD does not show many symptoms until its later stages, and since its symptoms can often be non-specific, it is important to schedule routine screenings.
Early intervention is vital to successful CKD treatment, so getting routine screenings despite your personal risk factors is key to catching the disease early. With World Kidney Day coming up, now is a great time to schedule an appointment with your urologist to discuss your kidney health.