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SEX DIFFERENCES IN ENDOTHELIAL FUNCTION IN CHRONIC KIDNEY DISEASE.

Vascular dysfunction plays an important role in the etiology of chronic kidney disease (CKD), and is associated with cardiovascular diseases (CVD). Sex differences in vascular function are common in clinical and non-clinical populations. However, no data exist in individuals with CKD. The following study tested the hypothesis that sex and/or aging differences exist on vascular function in patients with CKD. Endothelium dependent dilation (EDD) [measured via brachial artery flow-mediated dilation] and endothelium independent dilation (EID) [via nitroglycerin-mediated dilation] were assessed. Analyses were adjusted for several variables that could influence vascular function (diabetes, CVD, blood pressure). Women in general, had higher EDD values than men (6.5±4.9 vs. 4.4±3.4%); however, EID did not differ among these groups. In younger men and women (<55yrs), EDD and EID were higher (P<0.05) than their older (≥55yrs) counterparts (EDD: 7.0±4.1 vs. 4.4±3.8%; EID: 24.0±9.6 vs. 18.3±9.2%). Additionally, younger women exhibited a higher (P<0.05) EDD and EID compared with the younger males (EDD: 9.5±6.4 vs. 5.1±3.8%; P=0.01; EID: 24.0±9.6 vs. 18.3±9.2%). No differences in EDD and EID were present between older men and women with CKD. Diabetes independently predicted lower EID, but not EDD in men and women. Blood pressure and CVD did not predict EDD or EID. This is the first study to show significant sex differences in vascular function. Moreover, these differences are evident between younger men and women with CKD, but are abolished with age. Additional studies are needed to better understand the mechanisms that may underlie sex differences in vascular dysfunction with CKD.