Sex disparities in the risk of urgent dialysis following acute aortic dissections in Japan

The global outcome of acute aortic dissection (AD) remains poor, with a high risk of the need for urgent dialysis. This study aimed to clarify the association between sex and the requirement for urgent dialysis within 30 days after admission among patients with AD. This study included 79,998 cases who were hospitalized due to AD in Japan from 2010 to 2020 using an administrative claims database. The association between the risk of urgent dialysis and sex was investigated using the Fine and Gray model. Patients were classified into two groups based on the Stanford classification: type A AD (TAAD) and type B AD (TBAD). The lower subdistribution hazard ratio (SHR) in women was observed in both groups: TAAD (SHR: 0.58, 95% confidence interval [CI]: 0.54–0.62); TBAD (SHR: 0.49, 95% CI: 0.41–0.58). Our study revealed that women had a lower risk of requiring urgent dialysis than men in TAAD and TBAD. [Display omitted] •We found a link between sex and the risk of urgent dialysis in aortic dissections•The Fine and Gray model showed a lower risk of requiring urgent dialysis in women•Further research is needed to unveil the mechanism of the sex-vascular-kidney axis Cardiovascular medicine; Public health