The Impact of Sex on KRT in Acute Kidney Injury
Bibliographic record
Abstract
Key Points Initiation and outcome of KRT did not differ by sex. Accelerated initiation of KRT did not confer better survival to either women or men. Continuous KRT dose and ultrafiltration intensity were higher in women and not fully explained by patient weight. Background The purpose of this study was to evaluate whether sex modifies the initiation, prescription, or outcome of KRT or the relationship between KRT initiation strategy and patient outcomes. Methods We performed a secondary analysis of Standard versus Accelerated Initiation of Renal Replacement Therapy in AKI (STARRT-AKI), a multinational randomized controlled trial comparing accelerated initiation and standard initiation of KRT in critically ill adults with AKI. The primary outcome was all-cause mortality at 90 days. Secondary and tertiary outcomes included renal recovery, mortality in the intensive care unit or hospital, and resource utilization. We used logistic and linear regression analyses and interaction testing to explore the effect of KRT initiation strategy on outcomes according to sex. Results A total of 2926 participants from STARRT-AKI were included in this secondary analysis, of whom 937 were female (32%). Women had a lower premorbid serum creatinine level and were more likely to be admitted with a medical diagnosis, especially sepsis, compared with men. KRT was initiated with equal frequency in men and women, although women received a higher KRT dose and ultrafiltration intensity. There was no difference in 90-day mortality between sexes, even after covariate adjustment, nor in the number of days alive and free of ventilation, in the intensive care unit, or in the hospital. Sex did not modify the association between KRT initiation strategy and survival, KRT dependence, or resource utilization. Conclusions In this secondary analysis of the STARRT-AKI trial, KRT initiation and outcome did not differ by sex. An accelerated strategy of KRT initiation did not confer better outcomes to either women or men. Clinical Trial registry name and registration number: STARRT-AKI ClinicalTrials.gov number, NCT02568722.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".