Kidney Week

Abstract: FR-PO027

Sex Disparities in the Risk of Urgent Dialysis following Acute Aortic Dissections in Japan: A Real-World, Nationwide Study

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Nakano, Yuta, Ome Medical Center, Ome, Tokyo, Japan

Yuta Nakano, MD

• Mandai, Shintaro, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Shintaro Mandai, MD, PhD, FASN

• Takahashi, Daiei, Musashino Sekijuji Byoin, Musashino, Tokyo, Japan

Daiei Takahashi, MD, PhD

• Ikenouchi, Ken, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Ken Ikenouchi

• Mori, Yutaro, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Yutaro Mori, MD, PhD, FASN

• Ando, Fumiaki, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Fumiaki Ando, MD, PhD

• Susa, Koichiro, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Koichiro Susa, MD, PhD

• Mori, Takayasu, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Takayasu Mori, MD, PhD

• Iimori, Soichiro, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Soichiro Iimori, MD, PhD

• Naito, Shotaro, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Shotaro Naito, MD, PhD

• Sohara, Eisei, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Eisei Sohara, MD, PhD

• Fushimi, Kiyohide, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Kiyohide Fushimi, MD, PhD

• Uchida, Shinichi, Tokyo Ika Shika Daigaku, Bunkyo-ku, Tokyo, Japan

Shinichi Uchida, MD, PhD

Background

The global outcome of acute aortic dissection (AD) remains poor, with a high risk of acute kidney injury (AKI) and the need for urgent dialysis. This study aimed to clarify the association between sex and the requirement for urgent dialysis within 30 days after admission among patients with AD.

Methods

This study included 83,297 cases who were hospitalized due to AD in Japan from 2010 to 2020 using an administrative claims database. The association between the risk of urgent dialysis within 30 days after admission and sex was investigated using cumulative incidence functions and the Fine and Gray model.

Results

There were 5,640 events of urgent dialysis. Patients were classified into two groups based on the Stanford classification: type A AD (TAAD) and type B AD (TBAD). In TAAD, the cumulative incidence of urgent dialysis at 30 days was 8.6% [95% confidence interval (CI): 8.1–9.0] in women and 15.2% (95% CI: 14.7–15.8) in men (p < 0.001) (Figure 1). In TBAD, the cumulative incidence was 1.6% (95% CI: 1.4–1.8) in women and 3.5% (95% CI: 3.3–3.7) in men (p < 0.001) (Figure 1). In adjusted models, lower subdistribution hazard ratios (SHRs) in women were observed in both groups: TAAD (SHR: 0.62, 95% CI: 0.58–0.67); TBAD (SHR: 0.59, 95% CI: 0.52–0.68).

Conclusion

Our study revealed that women had a lower risk of requiring urgent dialysis than men in TAAD and TBAD. Further research is needed to clarify the underlying role of sex in AKI in patients with AD.

Figure1