Evidence map›Paper›PMID 30409132›Full record

SynthesisBMC nephrology2018

Female sex reduces the risk of hospital-associated acute kidney injury: a meta-analysis.

Joel Neugarten, Ladan Golestaneh

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Joel NeugartenDepartment of Medicine, Nephrology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E. 210 St, Bronx, NY, 10467, USA. jneugart@montefiore.org.ORCID 0000-0002-6430-819X
Ladan GolestanehDepartment of Medicine, Nephrology Division, Montefiore Medical Center, Albert Einstein College of Medicine, 111 E. 210 St, Bronx, NY, 10467, USA. lgolesta@montefiore.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFemale sex has been included as a risk factor in models developed to predict the development of AKI. In addition, the commentary to the Kidney Disease Improving Global Outcomes Clinical Practice Guideline for AKI concludes that female sex is a risk factor for hospital-acquired AKI. In contrast, a protective effect of female sex has been demonstrated in animal models of ischemic AKI.

methodsTo further explore this issue, we performed a meta-analysis of AKI studies published between January, 1978 and April, 2018 and identified 83 studies reporting sex-stratified data on the incidence of hospital-associated AKI among nearly 240,000,000 patients.

resultsTwenty-eight studies (6,758,124 patients) utilized multivariate analysis to assess risk factors for hospital-associated AKI and provided sex-stratified ORs. Meta-analysis of this cohort showed that the risk of developing hospital-associated AKI was significantly greater in men than in women (OR 1.23 (1.11,1.36). Since AKI is not a single disease but instead represents a heterogeneous group of disorders characterized by an acute reduction in renal function, we performed subgroup meta-analyses. The association of male sex with AKI was strongest among studies of patients who underwent non-cardiac surgery. Male sex was also associated with AKI in studies which included unselected hospitalized patients and in studies of critically ill patients who received care in an intensive care unit. In contrast, cardiac surgery-associated AKI and radiocontrast-induced AKI showed no sexual dimorphism.

conclusionsOur meta-analysis contradicts the established belief that female sex confers a greater risk of AKI and instead suggests a protective role.

Indexed as

HospitalizationSex CharacteristicsAcute Kidney InjuryFemaleHumansIatrogenic DiseaseMaleRisk FactorsAcute kidney injuryAcute renal failureGenderMeta-analysisSystematic review

Identifiers

PMID30409132
PMCPMC6225636

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.