Investigation of the Effect of Gender on Blood Parameters in Acute Renal Failure in Patients Presenting to the Emergency Department of a Hospital

Year 2025, Volume: 7 Issue: 2, 7 - 12, 01.09.2025

Bilgehan Demir , Turgut Dolanbay , Süleyman Nogay , Fatih Tan Ömer Faruk Öngenli

Abstract

Aim:
Acute renal failure (ARF) is a sudden change in renal function that prevents the excretion of nitrogenous wastes and disrupts the body's fluid and electrolyte balance. Identification of ARF risk factors and development of indicators that predict mortality are crucial to improve the success of medical care. We aim to evaluate the effect of age and gender factors in patients with ARF and to evaluate the course and frequency of the disease in female patients compared to male patients.

Methods:
The data of adult patients over 18 years of age who were hospitalized with a diagnosis of ARF
between 01.02.2025-01.03.2025 in the emergency department of Malatya Training and Research Hospital were retrospectively analyzed. Blood laboratory parameters were recorded and analyzed to determine whether these data were positively or negatively associated with gender.

Results:
A statistically significant difference was found between age and gender in patients with ARF (p= 0.004). Female patients with ARF were older than male patients. There was a statistically significant relationship between creatinine level and gender in patients with ARF (p=0,017). Creatinine levels were higher in male ARF patients. There was no statistically significant difference between plt, hb, htc, ALT and HALP score and gender (p values 0.384; 0.078; 0.221;0.221; 0.189; 0.174, respectively).

Conclusions:
The finding in our study that ARF occurs at older ages compared to men may be explained by the interaction of biological, hormonal, clinical and sociocultural factors. The renal protective effects of estrogen are realized through protection of vascular structure, support of glomerular iltration rate (GFR) and reduction of oxidative stress. However, the decrease in estrogen levels in the postmenopassusal period may be an important factor in the more rapid deterioration of renal function. The pro-inflammatory properties of testosterone and increased oxidative stress, as well as the earlier development of hypertension, atherosclerosis and chronic kidney disease in men, may be another reason why ARF occurs at a younger age in men compared to women.We found that creatinine levels were significantly higher in male patients with ARF compared to female patients. Men are known to have more muscle mass in general compared to women and this may lead to higher creatinine levels in men.

Keywords

akut renal failure , oxsidative stress , testosterone , estrogene

Ethical Statement

Our study was initiated after obtaining the ethics committee approval numbered 2025/74 dated 12.05.2025 from the non-interventional ethics committee of Malatya Turgut Ozal University Faculty of Medicine.

Supporting Institution

none

Thanks

This manuscript is original and unpublished and not being considered for publication elsewhere. In addition there is no conflict of interest between authors. Thank you for considering our manuscript for publication

3. Basamak Bir Hastanenin Acil Servisine Başvuran Hastalarda, Cinsiyetin Akut Böbrek Yetmezliğindeki Kan Paremetrelerine Etkisinin İncelenmesi

Abstract

Aim:

Akut böbrek yetmezliği (ABY), azotlu atıkların vücuttan atılmasını engelleyecek ve vücudun sıvı ve elektrolit dengesini bozacak kadar böbrek fonksiyonlarında meydana gelen ani değişmedir. ABY risk faktörlerinin belirlenmesi ve mortaliteyi öngören göstergelerin geliştirilmesi, tıbbi bakımın başarısını artırmak için oldukça önemlidir. ABY gelişen hastalarda yaş ve cinsiyet faktörlerinin etkisi değerlendirilmek ve kadın hastaların erkeklere göre hastalığın seyri, sıklığını değerlendirmek istiyoruz.

Methods:

Malatya Eğitim ve Araştırma Hastanesi acil servisinden 01.02.2025-01.03.2025 tarihleri arasında ABY tanısı ile yatışı yapılan 18 yaş üstü yetişkin hastaların verileri retrospektif olarak incelenmiştir. Kan laboratuar parametreleri kaydedilmiş ve incelemesi yapılarak bu verilerin cinsiyet ile olumlu ya da olumsuz varsa ilişkisi tespit edilmeye çalışılmıştır.

Results:

ABY li hastalarda yaş ile cinsiyet arasında istatistiksel olarak anlamlı farklılık tespit edilmiştir (p= 0,004). ABY’ li kadın hastalar erkeklere göre daha ileri yaşlara sahiptir. ABY’li hastalarda kreatinin düzeyi ile cinsiyet arasında istatistiksel olarak anlamlı ilişki tespit edilmiştir (p=0,017). Erkek ABY hastalarında kreatinin düzeyi daha yüksek seyretmektedir. Plt, hb, htc, ALT ve HALP skoru ile cinsiyet arasında istatistiksel olarak anlamlı farklılık tespit edilmemiştir (sırasıyla p değerleri 0,384; 0,078; 0,221; 0,189; 0,174).


Conclusions:

Çalışmamızda tespit edilen, ABY’nin erkeklere kıyasla daha ileri yaşlarda ortaya çıktığı sonucunu biyolojik, hormonal, klinik ve sosyokültürel faktörlerin etkileşimi ile açıklanabilir. Östrojenin renal koruyucu etkileri, vasküler yapının korunması, glomerüler filtrasyon hızının (GFR) desteklenmesi ve oksidatif stresin azaltılması yoluyla gerçekleşmektedir. Ancak menopoz sonrası dönemde östrojen seviyelerindeki azalma, böbrek fonksiyonlarının daha hızlı bozulmasında önemli bir etken olabilir. Testosteronun proinflamatuar özellikleri ve oksidatif stresin artmasına, erkekte hipertansiyon, ateroskleroz ve kronik böbrek hastalığının daha erken yaşlarda gelişmesi, ABY’nin erkeklerde kadınlara kıyasla daha genç yaşlarda ortaya çıkmasının bir başka sebebi olduğunu düşündürebilir. ABY tanısı alan erkek hastaların kreatinin düzeylerinin kadın hastalara kıyasla anlamlı derecede daha yüksek olduğunun tespit ettik. Erkeklerin kadınlara kıyasla genel olarak daha fazla kas kütlesine sahip olduğu bilinmektedir ve bu durum, erkeklerde kreatinin seviyelerinin daha yüksek olmasına yol açabilir

Keywords

akut böbrek yetmezliğ , oksidatif stres , testesteron , östrojen

References

• Palevsky, Paul M. "Epidemiology of acute renal failure: the tip of the iceberg." Clinical Journal of the American Society of Nephrology 1.1 (2006): 6-7.
• Ympa, Yvonne Patricia, et al. "Has mortality from acute renal failure decreased? A systematic review of the literature." The American journal of medicine 118.8 (2005): 827-832.
• Macedo, Etienne, Josee Bouchard, and Ravindra L. Mehta. "Renal recovery following acute kidney injury." Current opinion in critical care 14.6 (2008): 660-665.
• Ishani, Areef, et al. "Acute kidney injury increases risk of ESRD among elderly." Journal of the American Society of Nephrology 20.1 (2009): 223-228.
• Bagshaw, Sean M., et al. "Early acute kidney injury and sepsis: a multicentre evaluation." Critical care 12.2 (2008): R47.
• Silbiger, Sharon R., and Joel Neugarten. "The impact of gender on the progression of chronic renal disease." American journal of kidney diseases 25.4 (1995): 515-533.
• Chen, Chen, Gin-Fu, and Chris Baylis. "In vivo renal arginine release is impaired throughout development of chronic kidney disease." American Journal of Physiology-Renal Physiology 298.1 (2010): F95-F102.
• Neugarten, Joel. "Gender and the progression of renal disease." Journal of the American Society of Nephrology 13.11 (2002): 2807-2809.
• Yanes, Licy L., et al. "Cardiovascular-renal and metabolic characterization of a rat model of polycystic ovary syndrome." Gender medicine 8.2 (2011): 103-115.
• Carrero, Juan-Jesus, et al. "Chronic kidney disease, gender, and access to care: a global perspective." Seminars in Nephrology. Vol. 37. No. 3. WB Saunders, 2017.
• Sengul, Sule, et al. "Hypertension and chronic kidney disease in Turkey." Kidney International Supplements 3.4 (2013): 308-311.
• Miller, Paul D., et al. "Efficacy and safety of romosozumab among postmenopausal women with osteoporosis and mild‐to‐moderate chronic kidney disease." Journal of Bone and Mineral Research 37.8 (2020): 1437-1445.
• Dülek, Hatice, Zeynep Tuzcular Vural, and Işık Gönenç. "Kardiyovasküler hastalıklarda risk faktörleri." The Journal of Turkish Family Physician 9.2 (2018): 53-58.
• Taș, F. S., et al. "Causes of mortality in acute and chronic renal failure." Fırat Medical Journal 16.3 (2011): 120-124.
• Alebiosu, C. O., and O. E. Ayodele. "The global burden of chronic kidney disease and the way forward." Ethnicity & disease 15.3 (2005): 418-423.
• Kim, Catherine, et al. "Changes in kidney function during the menopausal transition: the Study of Women's Health Across the Nation (SWAN)–Michigan site." Menopause 27.9 (2020): 1066-1069.
• Leschke, M., et al. "Serum levels and urine excretion of L-carnitine in patients with normal and impaired kidney function." Klinische Wochenschrift 62.6 (1984): 274-277.
• Simsek, Yeliz, et al. "Analysis of Contrast-Induced Nephropathy in Patient with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention in the Emergency Department." Anatolian Journal of Emergency Medicine 4.2 (2021): 39-42.
• Delanaye, Pierre, Etienne Cavalier, and Hans Pottel. "Serum creatinine: not so simple!." Nephron 136.4 (2017): 302-308.
• Nitsch, Dorothea, et al. "Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis." Bmj 346 (2013).
• Levey, Andrew S., and Josef Coresh. "Chronic kidney disease." The lancet 379.9811 (2012): 165-180.
• Yarar, Mine Nihan and Eda Parlak. “Kreatinin Sporcular Üzerindeki Etkisi”. Toros University Journal of Food, Nutrition and Gastronomy, 3.2 (2024): 197-204.
• Shlipak, Michael G., et al. "Cystatin C versus creatinine in determining risk based on kidney function." New England Journal of Medicine 369.10 (2013): 932-943.