Evidence map›Paper›PMID 41820601›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Examining the role of biologic sex on kidney outcomes in preterm neonates: A secondary analysis of the PENUT/REPAIReD study.

Michelle C Starr, Russell Griffin, Heidi J Steflik, Krithika Lingappan, Matt Gillen, David T Selewski, David J Askenazi, Shina Menon, Cara L Slagle, Danielle E Soranno

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Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Michelle C StarrDivision of Pediatric Nephrology, Department of Pediatrics, Indiana University School of Medicine, 410 W 10 Street, Suite 2000A, Indianapolis, IN, 46202, USA. mcstarr@iu.edu.ORCID http://orcid.org/0000-0001-9412-8950
Russell GriffinDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Heidi J SteflikDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
Krithika LingappanDivision of Neonatology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Matt GillenDivision of Pediatric Nephrology, Emory University School of Medicine, Atlanta, GA, USA.
David T SelewskiDivision of Pediatric Nephrology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
David J AskenaziDivision of Pediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Shina MenonDivision of Pediatric Nephrology, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
Cara L SlagleDivision of Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Danielle E SorannoDivision of Pediatric Nephrology, Department of Pediatrics, Indiana University School of Medicine, 410 W 10 Street, Suite 2000A, Indianapolis, IN, 46202, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBiological sex plays a crucial role in the pathophysiology of morbidities related to preterm birth. Studies specifically investigating the role of biological sex in neonatal kidney disease are lacking. This study aimed to determine the association between biological sex and kidney outcomes in preterm infants. We hypothesized that male infants would be more likely to have poor kidney outcomes, including acute kidney injury (AKI), hypertension and chronic kidney disease. Given data on the relationship between sex, AKI and lung disease, we also evaluated lung disease as a secondary outcome.

methodsRetrospective analysis of the Preterm Erythropoietin Neuroprotection Trial data. For adjusted models, we used covariates associated with adverse outcomes a priori (gestational age, SGA status) and a lasso regression. AKI was defined using creatinine only neonatal modified KDIGO criteria and bronchopulmonary dysplasia (BPD) by Neonatal Research Network criteria.

resultsOf the 923 infants included, 479 (51.8%) were male. AKI was more common among males (aOR 1.31, 95%CI 1.00-1.74). Hypertension was nearly twice as common in males (66.4% vs. 51.5%, p < 0.001) and remained after adjustment (aOR 1.91, 95%CI 1.32-2.77). Severe BPD was more common in males (33.4% vs. 24.3%, p = 0.0024), which persisted after adjustment (aOR 1.65, 95%CI 1.22-2.23). This association was not fully mitigated by AKI exposure.

conclusionsWe describe differences in kidney outcomes and BPD by sex. Male sex is associated with an increased risk of AKI and hypertension. Research efforts focused on the mechanisms underlying sex-specific differences are needed for the identification of novel therapies that benefit both sexes.

Indexed as

Acute Kidney InjuryBronchopulmonary DysplasiaHypertensionRenal Insufficiency, ChronicFemaleGestational AgeHumansInfant, NewbornInfant, PrematureMaleRetrospective StudiesRisk FactorsSex FactorsAcute kidney injuryChronic kidney diseaseChronic lung diseaseHypertensionPrematurity

Identifiers

PMID41820601
PMCPMC13337948

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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.