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Abstract: SA-OR08

The Association of Female Sex Hormones and AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials


  • Golestaneh, Ladan, Albert Einstein College of Medicine, Bronx, New York, United States
  • Ehtesham, Nahian, Albert Einstein College of Medicine, Bronx, New York, United States
  • Basalely, Abby Miriam, Northwell Health, New Hyde Park, New York, United States
  • Reidy, Kimberly J., Albert Einstein College of Medicine, Bronx, New York, United States
  • Neugarten, Joel, Albert Einstein College of Medicine, Bronx, New York, United States

Women have a lower risk of chronic kidney disease progression; however, controversy exists as to the relative roles of comorbid, biological, and socioeconomic factors.Whether the reno-protective effects of female gender extend to AKI remains to be established.


Our cohort consisted of hospitalized patients without kidney failure in the Montefiore Health System, Bronx, NY, from October 1, 2015, to December 31, 2018.We defined community-acquired AKI(CAAKI) as meeting criteria defined by KDIGO within the first 48 hours of admission and hospital-acquired AKI(HAAKI) as to a within 48-hour window rise in creatinine occurring after 48 hours of admission and before discharge.We categorized age into prepubertal (<16 years), adult (16-55years), and post-menopausal (>55 years).We used logistic regression and stratified models by age category to examine the association of sex with AKI in progressive models adjusting for:1-age and race/ethnicity only, 2-addition of previous comorbidity, 3-addition of census tract level socioeconomic status (SES) normalized to the NY state mean SES.


Of the 286,383 hospitalizations, 120,711(42.1%) were men, 30,576 (10.7%) were White, and 82,505(28.8%) were Black, 44,172 (15.4%) were prepubertal, 100,115(35.0%) were adult and 142,101(49.6%) were older than 55 years. Of the 56,731 (19.8%) who developed AKI, 33,207(58.5%) had HAAKI and 23, 524(41.5%) had CAAKI. Males had a higher odds of developing both types of AKI (1.46 (1.43-1.49) in HAAKI and 1.31(1.27-1.34) in CAAKI). The odds of AKI were higher in males in all 3 age categories but was strongest in adults (Table 1). Adjustment for comorbidity attenuated the male risk in adults only, adjustment for socio-economic status did not change the strength of the association meaningfully.


Men are more likely than women to develop AKI. The attenuation of sexual dimorphism in AKI incidence before puberty and after menopause suggests that female sex hormones are protective in AKI.