The following is a summary of “Sex bias in prediction and diagnosis of cardiac surgery associated acute kidney injury,” published in the May 2024 issue of Nephrology by Demirjian et al.
The female sex is known as a risk factor for acute kidney injury after cardiac surgery.
Researchers conducted a retrospective study to determine whether gender is a direct risk factor for cardiac surgery-associated acute kidney injury (CS-AKI) or whether it influences how peri-operative changes in serum creatinine relate to CS-AKI.
They studied adults having cardiac surgery (2000 to 2019) at a single U.S. center. The primary focus was on patient sex from electronic medical records, and the main outcome of CS-AKI was tracked within 2 weeks post-surgery.
The results showed 58,526 patients, 33% (n=19,353) were female, AKI occurred in 22% (n=12,934) based on ≥0.3 mg/dL or ≥50% rise in serum creatinine. Moderate to severe AKI in 5.7% (n=3320) and 1.7% (n=1018) needed dialysis within 2 weeks of surgery. Females had a higher AKI risk based on pre-op serum creatinine (OR 1.35, 95% CI, 1.29-1.42) but were lower using estimated glomerular filtration (OR 0.90, 95% CI, 0.86-0.95). Moderate to severe CS-AKI risk from peri-op serum creatinine changes was higher in females (P<0.0001), influenced by pre-op kidney function (P<0.0001).
Investigators concluded that the link between patient sex and CS-AKI varies based on how pre-op kidney function was defined and that using absolute changes in serum creatinine might lead to different outcome classifications.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03614-x#Abs1
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