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Analysis challenges notion that women face higher kidney risks after heart surgery

American Society of Nephrology

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  • Women are more likely than men to develop kidney damage following cardiovascular surgery, but researchers found no association between sex and risk of kidney damage when they analyzed studies that took patient characteristics and other factors into account.

Washington, DC (October 20, 2016) -- Contrary to generally accepted beliefs, a new analysis indicates that women do not have a higher risk than men for developing kidney damage after cardiovascular surgery when adjustments are made for comorbidities. The findings appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Acute kidney injury (AKI), an abrupt decline in kidney function, is an increasingly prevalent and potentially serious condition that can arise following major surgery, often because the kidneys are deprived of normal blood flow during the procedure. Researchers have wondered why women are more likely than men to develop AKI following cardiovascular surgery, but the opposite is true after general surgery.

To investigate, Joel Neugarten, MD (Albert Einstein College of Medicine) and his colleagues performed a systematic review and meta-analysis of relevant studies published between January 1978 and December 2015. The analysis included 64 studies with 1,057,412 participants.

When they combined all studies that provided gender-specific data, the researchers found that female sex was associated with an increased risk of AKI following cardiovascular surgery, but this link was not seen in studies in which certain stringent classification methods (called RIFLE, AKIN or KDIGO criteria) were used to define AKI. There was also no association between sex and AKI risk when the investigators focused solely on studies that took patient characteristics and other factors into account. For example, many studies have shown that women undergoing cardiovascular surgery tend to have a higher burden of comorbidities and worse cardiovascular health than men.

"We have disputed the commonly held notion that women are at greater risk for acute kidney injury after cardiovascular surgery," said Dr. Neugarten.

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Study co-authors include Sandipani Sandilya MD, Beenu Singh, MD, and Ladan Golestaneh, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Sex and the Risk of Acute Kidney Injury (AKI) Following Cardio-thoracic Surgery: A Meta-analysis," will appear online at http://cjasn.asnjournals.org/ on October 20, 2016, doi: 10.2215/CJN.03340316.

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