Kidney Week

Abstract: SA-PO0306

Effect of Sex on AKI in Hospitalised Patients Outside the Intensive Care Unit: Insights from Secondary Analysis of the PERFORM-AKI Study

Session Information

• AKI: Epidemiology and Risk Factors
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Chang, Olivia, Concord Repatriation General Hospital, Concord, New South Wales, Australia

Olivia Chang

• Arulratnam, Bhranavi, Macquarie University, Sydney, New South Wales, Australia

Bhranavi Arulratnam

• Higgins, Kathryn, The George Institute for Global Health, Sydney, New South Wales, Australia

Kathryn Higgins, PhD

• Myton, Rimma, The George Institute for Global Health, Sydney, New South Wales, Australia

Rimma Myton

• Killen, John P., Northern Beaches Hospital, Frenchs Forest, New South Wales, Australia

John P. Killen, MBBS

• Gallagher, Martin P., The George Institute for Global Health, Sydney, New South Wales, Australia

Martin P. Gallagher, MBBS, PhD

• Wang, Amanda Y., The George Institute for Global Health, Sydney, New South Wales, Australia

Amanda Y. Wang, MD, MS, MSc, PhD

Background

Acute kidney injury (AKI) poses an escalating challenge to hospital clinicians, with the incidence of AKI in Australia growing by 4% per year. Females are protected from AKI based on previous studies. Current literature on the impact of sex on AKI is mostly derived from intensive care (ICU) settings. The association between sex and AKI in the non-ICU setting remains unclear.

Methods

PERFORM-AKI was a multi-centre, prospective cohort study across five healthcare facilities in New South Wales, Australia. Data was prospectively collected at the time of initial renal review and follow up data collected at time of discharge or two weeks after initial diagnosis (whichever was first). Patient demographics are presented using descriptive statistics, and multivariate analyses performed to identify any association between sex and the incidence, severity, and outcomes of AKI.

Results

The study included a total of 616 patients with non-ICU AKI for analysis, of whom 350 were male (56.8%) and 266 were female (43.2%). The mean age was 74.9 years (SD 14.5), 87.2% of females were >60 years and 84.6% of males were >60 years. Females had a lower median baseline creatinine than males (95 vs 120 umol/L). There was a similar distribution of AKI severity based on KDIGO AKI classification between females and males. Composite outcome of doubling of serum creatinine, requirement for renal replacement therapy (RRT) and mortality was similar between females and males (22.9% vs 22.0%). Multivariate analysis showed no significant association between sex and severity of AKI nor with risk of AKI progression. However, females were independently associated with increased odds of partial or full renal recovery (OR 1.77, p=0.011). Females of peri-menopausal age (45-60 years) were associated with reduced odds of developing the composite outcome (OR 0.98, p=0.012).

Conclusion

This study showed a higher incidence of non-ICU AKI in males than females. Distribution of AKI severity was similar between both groups and there was no significant association between sex and progression of AKI. However, females had higher odds of partial or full renal recovery than males and females of pre- or peri-menopausal age were protected against AKI associated morbidity than those of post-menopausal age.