Sex and mortality in septic severe acute kidney injury.

Acute Kidney Injury / mortality Adult Aged Cohort Studies Female Humans Male Menopause / physiology Middle Aged Proportional Hazards Models Renal Replacement Therapy / statistics & numerical data Risk Factors Sepsis / mortality Sex Factors Survival Analysis
Acute kidney injury Mortality Renal replacement therapy Sepsis Sex

Journal

Journal of critical care
ISSN: 1557-8615
Titre abrégé: J Crit Care
Pays: United States
ID NLM: 8610642

Informations de publication

Date de publication:
02 2019
Historique:
received: 03 05 2018
revised: 08 10 2018
accepted: 20 10 2018
pubmed: 6 11 2018
medline: 11 2 2020
entrez: 3 11 2018
Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1016/j.jcrc.2018.10.017 PMID: 30388491
pubmed: 30388491
pii: S0883-9441(18)30632-4
doi: 10.1016/j.jcrc.2018.10.017
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

70-76

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Zachary O'Brien (Z)

Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Alan Cass (A)

Menzies School of Health Research, Charles Darwin University, Darwin, Winnellie, NT, Australia.

Louise Cole (L)

Department of Intensive Care, Nepean Hospital, Sydney, Australia.

Simon Finfer (S)

The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia.

Martin Gallagher (M)

The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia.

Colin McArthur (C)

Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.

Shay McGuiness (S)

Cardiovascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand.

John Myburgh (J)

The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia.

Rinaldo Bellomo (R)

Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Johan Mårtensson (J)

Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. Electronic address: johan.martensson@sll.se.

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Classifications MeSH

questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Maladies du rein › Insuffisance rénale › Atteinte rénale aigüe › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Développement sexuel › Climatère › Ménopause › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Modèles des risques proportionnels › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Thérapeutique › Traitement substitutif de l'insuffisance rénale › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Inflammation › Sepsie › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs sexuels › Sex and mortality in septic severe acute kidney injury.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Sex and mortality in septic severe acute kidney injury.