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August 20, 2026Emergency Care and MedicineOpen Access

Sex Differences in Acute Kidney Injury After Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock

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Authors

NDNiti DalalTETHIERRY EDWARDSAMA. Mohsen

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Overview

Retrospective cohort study reveals a lower risk of acute kidney injury in female patients undergoing venoarterial ECMO for cardiogenic shock, indicating sex-specific renal vulnerabilities.

Key Points

  • To determine whether sex-based differences exist in the 30-day risk of acute kidney injury and other short-term clinical outcomes among adult patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock.
  • Conducted a retrospective multicenter cohort study using the TriNetX U.S. Collaborative Network (2012–2025) identifying adults with cardiogenic shock supported with VA-ECMO.
  • Excluded patients with baseline diagnosis-coded acute kidney injury (AKI) and performed 1:1 propensity score matching on 23 clinical characteristics, yielding 1,100 matched women and 1,100 matched men.
  • Diagnosis-coded AKI occurred in 20.2% of women (222/1,100) compared with 25.1% of men (276/1,100) (risk ratio 0.80, 95% CI 0.69–0.94; hazard ratio 0.78, 95% CI 0.65–0.93; p = 0.005).
  • All-cause 30-day mortality was 29.5% in both groups (risk ratio 1.00, 95% CI 0.88–1.14), with no significant differences in newly coded sepsis (5.1% vs. 6.3%) or ischemic stroke (4.0% vs. 3.2%).

Cite This Study

Dalal et al. (2026) studied this question.

synapsesocial.com/papers/6a86b56c8a91293e6a1ccbcchttps://doi.org/10.3390/ecm3030026
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