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Sex Differences in Acute Kidney Injury
Joel Neugarten1, Ladan Golestaneh1
1Renal Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Seminars in Nephrology
|June 19, 2022
Summary
Female sex protects against kidney injury in animal models, but is considered a risk in humans. This review suggests male sex, not female sex, is linked to acute kidney injury (AKI).
Area of Science:
- Nephrology
- Renal Physiology
- Sex Differences in Disease
Background:
- Female sex is known to protect against chronic progressive kidney disease.
- Sexual dimorphism in acute kidney injury (AKI) is recognized, with animal studies showing female protection against ischemic AKI.
- Clinical consensus considers female sex an independent risk factor for human AKI.
Purpose of the Study:
- To re-evaluate the association between sex and acute kidney injury (AKI).
- To challenge the prevailing clinical view that female sex is a risk factor for AKI.
- To present evidence supporting male sex as being associated with AKI development.
Main Methods:
- Systematic review of experimental and clinical literature.
- Analysis of data from animal studies on ischemic AKI.
- Evaluation of human clinical data regarding AKI risk factors.
Main Results:
- Animal studies consistently demonstrate renoprotection in females against ischemic AKI.
- Contrary to established clinical opinion, this review's findings indicate male sex is associated with AKI development.
- The data challenges the consensus that female sex is an independent risk factor for AKI.
Conclusions:
- The protective effect of female sex observed in animal models may extend to human AKI.
- Male sex, not female sex, is associated with the development of acute kidney injury.
- Clinical understanding of sex differences in AKI requires re-evaluation based on current evidence.
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