"No sex differences in the incidence, risk factors and clinical impact of acute kidney injury in critically ill patients with sepsis"

作者全名："Peng, Junnan; Tang, Rui; Yu, Qian; Wang, Daoxin; Qi, Di"

作者地址："[Peng, Junnan; Tang, Rui; Yu, Qian; Wang, Daoxin; Qi, Di] Second Affiliated Hosp Chongqing Med Univ, Dept Resp & Crit Care Med, Chongqing, Peoples R China"

通信作者："Wang, DX; Qi, D (通讯作者)，Second Affiliated Hosp Chongqing Med Univ, Dept Resp & Crit Care Med, Chongqing, Peoples R China."

来源：FRONTIERS IN IMMUNOLOGY

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000833967500001

JCR分区：Q1

影响因子：7.3

年份：2022

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：sepsis; AKI; sex; intensive care; critically ill

摘要："BackgroundSex-stratified medicine is an important aspect of precision medicine. We aimed to compare the incidence and risk factors of acute kidney injury (AKI) for critically ill men and women with sepsis. Furthermore, the short-term mortality was compared between men and women with sepsis associated acute kidney injury (SA-AKI). MethodThis was a retrospective study based on the Medical Information Mart for Intensive Care IV database. We used the multivariable logistic regression analysis to evaluate the independent effect of sex on the incidence of SA-AKI. We further applied three machine learning methods (decision tree, random forest and extreme gradient boosting) to screen for the risk factors associated with SA-AKI in the total, men and women groups. We finally compared the intensive care unit (ICU) and hospital mortality between men and women with SA-AKI using propensity score matching. ResultsA total of 6463 patients were included in our study, including 3673 men and 2790 women. The incidence of SA-AKI was 83.8% for men and 82.1% for women. After adjustment for confounders, no significant association was observed between sex and the incidence of SA-AKI (odds ratio (OR), 1.137; 95% confidence interval (CI), 0.949-1.361; p=0.163). The machine learning results revealed that body mass index, Oxford Acute Severity of Illness Score, diuretic, Acute Physiology Score III and age were the most important risk factors of SA-AKI, irrespective of sex. After propensity score matching, men had similar ICU and hospital mortality to women. ConclusionsThe incidence and associated risk factors of SA-AKI are similar between men and women, and men and women with SA-AKI experience comparable rates of ICU and hospital mortality. Therefore, sex-related effects may play a minor role in developing SA-AKI. Our study helps to contribute to the knowledge gap between sex and SA-AKI."

基金机构："National Natural Science Foundation of Chongqing, China [CQYC2020020321]"

基金资助正文："Funding This research was funded by National Natural Science Foundation of Chongqing, China(Grant NO. CQYC2020020321)."