Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19851
Title: Sex and mortality in septic severe acute kidney injury.
Authors: O'Brien, Zachary;Cass, Alan;Cole, Louise;Finfer, Simon;Gallagher, Martin;McArthur, Colin;McGuiness, Shay;Myburgh, John;Bellomo, Rinaldo;Mårtensson, Johan
Affiliation: Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
St George Clinical School, University of New South Wales, Sydney, NSW, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Cardiovascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
Menzies School of Health Research, Charles Darwin University, Darwin, Winnellie, NT, Australia
Department of Intensive Care, Nepean Hospital, Sydney, Australia
The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia
Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
Issue Date: 23-Oct-2018
EDate: 2018-10-23
Citation: Journal of critical care 2018; 49: 70-76
Abstract: 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). Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial. 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). 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19851
DOI: 10.1016/j.jcrc.2018.10.017
ORCID: 0000-0002-1650-8939
0000-0001-8739-7896
PubMed URL: 30388491
Type: Journal Article
Subjects: Acute kidney injury
Mortality
Renal replacement therapy
Sepsis
Sex
Appears in Collections:Journal articles

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