Sex and mortality in septic severe acute kidney injury

Zachary O'Brien; Alan Cass; Louise Cole; Simon Finfer; M. Gallagher; Colin McArthur; Shay McGuiness; John Myburgh; Rinaldo Bellomo; Johan Mårtensson

doi:10.1016/j.jcrc.2018.10.017

Sex and mortality in septic severe acute kidney injury

Zachary O'Brien, Alan Cass, Louise Cole, Simon Finfer, M. Gallagher, Colin McArthur, Shay McGuiness, John Myburgh, Rinaldo Bellomo, Johan Mårtensson

Wellbeing and Preventable Chronic Disease

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: To investigate the relationship between sex and mortality and whether menopause or the intensity of renal replacement therapy (RRT) modify this relationship in patients with severe septic acute kidney injury (AKI).

Materials and methods: Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial.

Results: Of 724 patients, 458 (63.3%) were male and 266 (36.7%) were female. The mean delivered effluent flow rate was 25.6 ± 7.4 ml/kg/h (80 ± 15% of prescribed dose) in males and 27.4 ± 7.6 ml/kg/h (83 ± 15% of prescribed dose) in females (p = .01). A total of 237 (51.7%) males and 118 (44.5%) females died within 90 days of randomization (p = .06). The adjusted hazard ratio (HR) for 90-day mortality was significantly decreased in females as compared with males (HR 0.74, 95% CI 0.57 to 0.96, p = .02). The relationship between sex and mortality was not significantly altered by menopausal status (adjusted P value for interaction 0.99) or by RRT intensity allocation (adjusted P value for interaction 0.27).

Conclusions: In a cohort of patients with sepsis and severe AKI, female sex was associated with improved survival. The relationship between sex and survival was not altered by menopausal status or RRT intensity.

Original language	English
Pages (from-to)	70-76
Number of pages	7
Journal	Journal of Critical Care
Volume	49
Issue number	February
Early online date	23 Oct 2018
DOIs	https://doi.org/10.1016/j.jcrc.2018.10.017
Publication status	Published - Feb 2019

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10.1016/j.jcrc.2018.10.017

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title = "Sex and mortality in septic severe acute kidney injury",

abstract = "Purpose: To investigate the relationship between sex and mortality and whether menopause or the intensity of renal replacement therapy (RRT) modify this relationship in patients with severe septic acute kidney injury (AKI). Materials and methods: Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial. Results: Of 724 patients, 458 (63.3%) were male and 266 (36.7%) were female. The mean delivered effluent flow rate was 25.6 ± 7.4 ml/kg/h (80 ± 15% of prescribed dose) in males and 27.4 ± 7.6 ml/kg/h (83 ± 15% of prescribed dose) in females (p = .01). A total of 237 (51.7%) males and 118 (44.5%) females died within 90 days of randomization (p = .06). The adjusted hazard ratio (HR) for 90-day mortality was significantly decreased in females as compared with males (HR 0.74, 95% CI 0.57 to 0.96, p = .02). The relationship between sex and mortality was not significantly altered by menopausal status (adjusted P value for interaction 0.99) or by RRT intensity allocation (adjusted P value for interaction 0.27). Conclusions: In a cohort of patients with sepsis and severe AKI, female sex was associated with improved survival. The relationship between sex and survival was not altered by menopausal status or RRT intensity.",

author = "Zachary O'Brien and Alan Cass and Louise Cole and Simon Finfer and M. Gallagher and Colin McArthur and Shay McGuiness and John Myburgh and Rinaldo Bellomo and Johan M{\aa}rtensson",

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doi = "10.1016/j.jcrc.2018.10.017",

language = "English",

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T1 - Sex and mortality in septic severe acute kidney injury

AU - O'Brien, Zachary

AU - Cass, Alan

AU - Cole, Louise

AU - Finfer, Simon

AU - Gallagher, M.

AU - McArthur, Colin

AU - McGuiness, Shay

AU - Myburgh, John

AU - Bellomo, Rinaldo

AU - Mårtensson, Johan

PY - 2019/2

Y1 - 2019/2

N2 - Purpose: To investigate the relationship between sex and mortality and whether menopause or the intensity of renal replacement therapy (RRT) modify this relationship in patients with severe septic acute kidney injury (AKI). Materials and methods: Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial. Results: Of 724 patients, 458 (63.3%) were male and 266 (36.7%) were female. The mean delivered effluent flow rate was 25.6 ± 7.4 ml/kg/h (80 ± 15% of prescribed dose) in males and 27.4 ± 7.6 ml/kg/h (83 ± 15% of prescribed dose) in females (p = .01). A total of 237 (51.7%) males and 118 (44.5%) females died within 90 days of randomization (p = .06). The adjusted hazard ratio (HR) for 90-day mortality was significantly decreased in females as compared with males (HR 0.74, 95% CI 0.57 to 0.96, p = .02). The relationship between sex and mortality was not significantly altered by menopausal status (adjusted P value for interaction 0.99) or by RRT intensity allocation (adjusted P value for interaction 0.27). Conclusions: In a cohort of patients with sepsis and severe AKI, female sex was associated with improved survival. The relationship between sex and survival was not altered by menopausal status or RRT intensity.

AB - Purpose: To investigate the relationship between sex and mortality and whether menopause or the intensity of renal replacement therapy (RRT) modify this relationship in patients with severe septic acute kidney injury (AKI). Materials and methods: Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial. Results: Of 724 patients, 458 (63.3%) were male and 266 (36.7%) were female. The mean delivered effluent flow rate was 25.6 ± 7.4 ml/kg/h (80 ± 15% of prescribed dose) in males and 27.4 ± 7.6 ml/kg/h (83 ± 15% of prescribed dose) in females (p = .01). A total of 237 (51.7%) males and 118 (44.5%) females died within 90 days of randomization (p = .06). The adjusted hazard ratio (HR) for 90-day mortality was significantly decreased in females as compared with males (HR 0.74, 95% CI 0.57 to 0.96, p = .02). The relationship between sex and mortality was not significantly altered by menopausal status (adjusted P value for interaction 0.99) or by RRT intensity allocation (adjusted P value for interaction 0.27). Conclusions: In a cohort of patients with sepsis and severe AKI, female sex was associated with improved survival. The relationship between sex and survival was not altered by menopausal status or RRT intensity.

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JF - Journal of Critical Care

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Sex and mortality in septic severe acute kidney injury

Abstract

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