#6535 SEXUAL DIMORPHISMS OF ACUTE KIDNEY INJURY: DIVERGENT PERFORMANCES OF BIOMARKERS OR DIFFERENT MOLECULAR MECHANISMS?

Abstract Background and Aims Before implementing individualized strategies to prevent or treat acute kidney injury (AKI), identifying clusters of patients with common (or divergent) pathophysiological mechanisms, diagnosis criteria outcome is upmost importance. Method We compared the characteristics 1170 male female referred for cardiac surgery bypass (CBP) using multivariate logistic regression propension score-based analysis. Performances candidate urinary biomarkers neutrophil gelatinase-associated lipocalin (uNGAL), [IGFBP7].[TIMP-2] product (Nephrocheck), a recently developed AKI signature 204 peptides (PeptAKI) were compared, sex-dependent individual peptide changes studied. Results In these CBP-surgery, incidence severity (K/DIGO classification) similar in men women (about 25%), even after adjustment usual risk factors including baseline estimated glomerular filtration rate, age, diabetes mellitus, length CBP red blood cell transfusion. uNGAL, Nephrocheck PeptAKI strongly diverged between males females. overall cohort, as well sub-groups females, multi-markers outperformed uNGAL NephroCheck. Reanalysis included at single level suggested divergences mechanisms sexes. women, score-derived relied on indicating inflammation (including SERPINs, SAA1, osteopontin, uromodulin fragments) hemolysis (HBA1, HBB), whereas derived from stress-responsive protective gene tubular epithelial cells (VGF nerve growth factor) was dramatically less abundant developing AKI. Conclusion significant clinical biological differences sexual dimorphism performances, identified. Urinary signatures may help personalize prevention progression by giving both quantitative sex-related qualitative information molecular underlying