Study: Women, Girls at Lower Risk of Acute Kidney Injury

Boys and men carry a greater risk for acute kidney injury (AKI) than women and girls across all age groups, according to a recent study published in the American Journal of Kidney Disease. 

"Acute kidney injury is not a monolithic disorder, but rather a response to numerous different renal insults," said Ladan Golestaneh, MD, Professor of Medicine (Nephrology) at Yale School of Medicine and corresponding author of the study. "In this context, the sexual disparity we found was present across a wide spectrum of AKI causes."

The team, led by researchers from Yale School of Medicine and the Albert Einstein College of Medicine, examined data from more than 235,000 hospitalizations at a single health system from 2015 to 2019, including 53,926 occurrences of AKI. Stratifying the results by age and sex, researchers found men and boys had higher odds of developing AKI in all three age groups: 6 months to 16 years (OR 1.13), 17 years to 54 years (OR 1.7), and 55 or older (OR 1.35). 

The increased risk for men and boys was highest in the 17-54 age group, where researchers found male sex was associated with 70% greater risk of AKI. Researchers say estrogen and other female sex hormones may offer pre-menopausal women added protection. "Numerous other studies have primarily included post-menopausal women with low estrogen levels, thus masking the protective role of female sex," Dr. Golestaneh said. "Our study shows that the protection afforded by female sex is highest among menstruating women, is absent in prepubertal females and declines with the onset of menopause."

Researchers say prior studies in animals have shown a protective role for estrogen in acute kidney injury. "Our population-level study suggests estrogen is likely protective in human AKI as well," Dr. Golestaneh adds, "which could open the door for research into new therapeutic options."