August 2026: Examining the role of biologic sex on kidney outcomes in preterm neonates: A secondary analysis of the PENUT/REPAIReD study
August 2026
Reviewer: Chase Schoenenberger
Purpose of the Study: Biological sex has been found to be an important variable for kidney outcomes in older populations, however, studies investigating the role of biological sex in neonatal kidney diseases are lacking.
Study Design: Secondary analysis of the PENUT/REPAIReD study evaluating sex as a primary exposure. Short-term outcomes included acute kidney injury (AKI) and severe bronchopulmonary dysplasia (BPD). Long-term outcomes occurred two years later and included estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio (ACR) and blood pressure. Multivariable logistic regression was performed.
Sample characteristics: 923 neonates included, 479 (51.9%) male and 444 (48.1%) female, with a median birthweight of 800 grams. 780 neonates had long-term data.
Study Results: Males had a greater chance of developing AKI (aOR 1.31, 95% CI 1.001.74), severe BPD (aOR 1.65, 95% CI 1.222.23), and hypertension at two years of age (aOR 1.91, 95% CI 1.322.77) than females. AKI status did not mitigate the association between sex and severe BPD. Rates of low eGFR and albuminuria at 2 years did not differ significantly between sexes.
Implications: Male sex was associated with higher risk of AKI, hypertension, and severe BPD after adjusting for measured confounders. Sex-disaggregated studies are warranted in future neonatal kidney research.