Kidney Week

Abstract: FR-PO1155

Sex Hormones and Vascular Endothelial Function in Men and Women with CKD

Session Information

• CKD: Kidney Function and Extrarenal Complications
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Oh, Ester, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Ester Oh, PhD

• Ostrow, Anna, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Anna Ostrow, MPH

• Chonchol, Michel, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Michel Chonchol, MD, FASN

• Brunt, Vienna E., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Vienna E. Brunt, PhD

• Nowak, Kristen L., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Kristen L. Nowak, PhD, MPH

• Jovanovich, Anna, Bozeman Health, Bozeman, Montana, United States

Anna Jovanovich, MD

• Kendrick, Jessica B., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Jessica B. Kendrick, MD, MPH

• Moreau, Kerrie, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Kerrie Moreau, PhD

Background

Vascular endothelial dysfunction is common in chronic kidney disease (CKD) and independently predicts cardiovascular disease events. In older healthy females and males, lower estrogen and testosterone levels contribute to endothelial dysfunction, leading to higher cardiovascular risk. However, limited studies to date have examined the association of sex hormones with endothelial function in patients with CKD. As such, this study investigated if sex hormones are associated with endothelial function in adults with CKD.

Methods

Circulating levels of total testosterone (TT), free testosterone (FT), FT/TT ratio, estrone (E1), estradiol (E2), E1/E2 ratio, and TT/E2 ratio, were measured in males (age 29-81 years) and females (23-80 years) with stage 3-4 CKD, who participated in one of three completed clinical trials (PMID: 28784657 and 37228030; and NCT02209636 [in press]). The association of each sex hormone with brachial artery flow-mediated dilation (FMD_BA; a gold-standard measure of conduit artery endothelial function in humans) was assessed via multivariable linear regression.

Results

A total N=187 males (46% white; mean±SD age 61±11 y; eGFR 37±11 mL/min/1.73m²) and N=104 females (49% white; 61±12 y; eGFR 34±10 mL/min/1.73m²) were included. In males, FT/TT was positively associated with FMD_BA in the unadjusted model (β=1.59; 95% confidence interval 0.44–2.74). However, this association was attenuated following adjustment for age (Figure A). In females, TT, FT, and E2 tended to be associated with lower FMD_BA and E1/E2 with higher FMD_BA after adjusting for age (Figure B).

Conclusion

Sex hormones were not associated with FMD_BA in males and females with CKD. Further mechanistic research is needed to better understand sex differences in cardiovascular risk in patients with CKD.

Figure. The association of sex hormones with FMD_BA in males (A) and females (B), adjusted for age.

Funding

• Private Foundation Support