The association of several comorbidities, including diabetes mellitus, hypertension, cardiovascular disease, heart failure and chronic kidney or liver disease, with acute kidney injury (AKI) is well established. Evidence on the effect of sex and socioeconomic factors are scarce. This study was designed to examine the association of sex and socioeconomic factors with AKI and AKI-related mortality and further to evaluate the additional relationship with other possible risk factors for AKI occurrence. We included 3534 patients (1878 males with mean age 61.1 ± 17.7 and 1656 females 1656 with mean age 60.3 ± 20.0 years) admitted to Queen Elizabeth or Heartlands Hospitals, Birmingham, between October 2013 and January 2016. Patients were prospectively followed-up for a median 47.70 [IQR, 18.20] months. Study-endpoints were incidence of AKI, based on KDIGO-AKI Guidelines, and all-cause mortality. Data acquisition was automated, and information on mortality was collected from the Hospital Episode Statistics and Office of National Statistics. Socioeconomic status was evaluated with the Index of Multiple Deprivation (IMD). Incidence of AKI was higher in men compared to women (11.3% vs 7.1%; P < 0.001). Model regression analysis revealed significant association of male sex with higher AKI risk (OR, 1.659; 95% CI, 1.311–2.099; P < 0.001); this association remained significant after adjustment for age, eGFR, IMD, smoking, alcohol consumption, ethnicity, existing comorbidities and treatment (OR, 1.599; 95% CI, 1.215–2.103; P = 0.001). All-cause mortality was higher in patients with compared to those without AKI. Males with AKI had higher mortality rates in the first 6-month and 1-year periods after the index AKI event. The association of male sex with mortality was independent of socioeconomic factors but was not statistically significant after adjustment for existing comorbidities. Men are at higher risk of AKI and this association is independent from existing risk factors for AKI. The association between male sex and AKI-related mortality was not independent from existing comorbidities. A better understanding of factors associated with AKI may help accurately identify high-risk patients.

中文翻译：

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考虑到社会经济地位、种族、酒精摄入量和吸烟史后，急性肾损伤在男性中比女性更常见


多种合并症，包括糖尿病、高血压、心血管疾病、心力衰竭和慢性肾脏或肝脏疾病，与急性肾损伤 (AKI) 之间的关联已得到充分证实。关于性别和社会经济因素影响的证据很少。本研究旨在探讨性别和社会经济因素与 AKI 和 AKI 相关死亡率的关系，并进一步评估与 AKI 发生的其他可能危险因素的额外关系。我们纳入了 2013 年 10 月至 2016 年 1 月期间入住伯明翰伊丽莎白女王医院或哈特兰医院的 3534 名患者（1878 名男性，平均年龄 61.1 ± 17.7 岁，1656 名女性，1656 名平均年龄 60.3 ± 20.0 岁）。中位数 47.70 [IQR，18.20] 个月。研究终点是基于 KDIGO-AKI 指南的 AKI 发生率和全因死亡率。数据采集​​是自动化的，死亡率信息是从医院事件统计和国家统计办公室收集的。社会经济状况通过多重剥夺指数（IMD）进行评估。男性 AKI 发病率高于女性（11.3% vs 7.1%；P < 0.001）。模型回归分析显示男性与较高的 AKI 风险显着相关（OR，1.659；95% CI，1.311–2.099；P < 0.001）；在调整年龄、eGFR、IMD、吸烟、饮酒、种族、现有合并症和治疗后，这种相关性仍然显着（OR，1.599；95% CI，1.215-2.103；P = 0.001）。与没有 AKI 的患者相比，患有 AKI 的患者的全因死亡率更高。患有 AKI 的男性在 AKI 指数事件发生后的前 6 个月和一年内死亡率较高。 男性与死亡率的关联独立于社会经济因素，但在调整现有合并症后不具有统计学意义。男性发生 AKI 的风险较高，并且这种关联独立于现有的 AKI 风险因素。男性与 AKI 相关死亡率之间的关联并不独立于现有的合并症。更好地了解与 AKI 相关的因素可能有助于准确识别高危患者。