National Trends and Outcomes in Dialysis-Requiring Acute Kidney Injury in Heart Failure: 2002–2013

Correa, Ashish; Patel, Achint; Chauhan, Kinsuk; Shah, Harshil; Saha, Aparna; Dave, Maneesh; Poojary, Priti; Mishra, Abhishek; Annapureddy, Narender; Dalal, Shaman; Konstantinidis, Ioannis; Nimma, Renu; Agarwal, Shiv Kumar; Chan, Lili; Nadkarni, Girish N.; Pinney, Sean

doi:10.1016/j.cardfail.2018.05.001

Cited by 13 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed a substantial decline in the unadjusted and adjusted in-hospital mortality of patients on RRT in accordance with previous nationwide studies regarding AKI-D [4, 9, 19]. We observed a downward trend in in-hospital mortality in both patients starting CRRT and IRRT and in each group of patients categorized according to the main diagnosis category.…”

Section: Discussionsupporting

confidence: 90%

Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

et al. 2019

View full text Add to dashboard Cite

Background We aimed to examine recent trends in patient characteristics and mortality in patients with acute kidney injury (AKI) receiving renal replacement therapy (RRT), including continuous RRT (CRRT) and intermittent RRT (IRRT), in intensive care units (ICUs). Methods From the Diagnosis Procedure Combination database in Japan during 6 months (July–December) from 2007 to 2016, we identified patients with AKI who received RRT in ICUs. We restricted the study participants to those admitted to hospitals (in which both CRRT and IRRT were available) that participated in the Diagnosis Procedure Combination database for all 10 years. We examined the trends in patient characteristics and mortality overall, by RRT modality, and by main diagnosis category subgroup. Logistic regression was used to adjust for patient characteristics. Results We identified 51,758 patients starting RRT in 287 hospitals, including 39,471 (76.3%) and 12,287 (23.7%) patients starting CRRT and IRRT. The crude in-hospital mortality declined from 44.9 to 36.1% ( P for trend < 0.001). Compared with 2007, the adjusted odds ratio (aOR) for in-hospital mortality was 0.66 (95% confidence interval (CI) 0.60–0.72) in 2016, and the decreasing trend was observed in both patients starting CRRT (aOR 0.67, 95% CI 0.61–0.75) and IRRT (0.58, 0.45–0.74), and in all subgroups except for coronary artery disease: sepsis aOR 0.68 (95% CI 0.57–0.81); cardiovascular surgery 0.58 (0.45–0.76); coronary artery disease 0.84 (0.60–1.19); non-coronary heart disease 0.78 (0.64–0.94); central nervous system disorders 0.42 (0.28–0.62); trauma 0.39 (0.21–0.72); and other 0.64 (0.50–0.82). Conclusions This nationwide study confirmed a consistent decline in mortality among patients with AKI on RRT in ICUs. The adjusted mortality also declined during the study period; however, physiological variables were not measured in this study and it is possible that RRT may have been indicated for patients with less severe AKI in more recent years. Electronic supplementary material The online version of this article (10.1186/s13054-019-2468-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 90%

Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The unadjusted cohort consisted of 68 studies which included 232,586,252 patients (130,605,382 women and 101,970,870 men (Figs. 3 and 4 ) [ 29 , 31 – 34 , 36 , 38 , 42 , 43 , 45 , 47 , 57 – 112 ]. Studies could be divided into 7 distinct categories.…”

Section: Resultsmentioning

confidence: 99%

Female sex reduces the risk of hospital-associated acute kidney injury: a meta-analysis

Neugarten

Golestaneh

2018

BMC Nephrol

View full text Add to dashboard Cite

BackgroundFemale sex has been included as a risk factor in models developed to predict the development of AKI. In addition, the commentary to the Kidney Disease Improving Global Outcomes Clinical Practice Guideline for AKI concludes that female sex is a risk factor for hospital-acquired AKI. In contrast, a protective effect of female sex has been demonstrated in animal models of ischemic AKI.MethodsTo further explore this issue, we performed a meta-analysis of AKI studies published between January, 1978 and April, 2018 and identified 83 studies reporting sex-stratified data on the incidence of hospital-associated AKI among nearly 240,000,000 patients.ResultsTwenty-eight studies (6,758,124 patients) utilized multivariate analysis to assess risk factors for hospital-associated AKI and provided sex-stratified ORs. Meta-analysis of this cohort showed that the risk of developing hospital-associated AKI was significantly greater in men than in women (OR 1.23 (1.11,1.36). Since AKI is not a single disease but instead represents a heterogeneous group of disorders characterized by an acute reduction in renal function, we performed subgroup meta-analyses. The association of male sex with AKI was strongest among studies of patients who underwent non-cardiac surgery. Male sex was also associated with AKI in studies which included unselected hospitalized patients and in studies of critically ill patients who received care in an intensive care unit. In contrast, cardiac surgery-associated AKI and radiocontrast-induced AKI showed no sexual dimorphism.ConclusionsOur meta-analysis contradicts the established belief that female sex confers a greater risk of AKI and instead suggests a protective role.

show abstract

“…The results of our study are consistent with data from other non-AMI populations, which have demonstrated a steady increase in AKI prevalence. [17, 27, 28] In unselected AMI patients, Amin et al noted a decrease in the incidence and in-hospital mortality from AKI in all AMI patients. [13] They postulated that this may be partly due to greater recognition and the effective use of preventive strategies.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock

et al. 2019

View full text Add to dashboard Cite

BackgroundThere are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS.MethodsThis was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20% stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition.ResultsDuring this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3%) and hemodialysis use in 14,950 (3.4%). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001).ConclusionAKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.

show abstract

National Trends and Outcomes in Dialysis-Requiring Acute Kidney Injury in Heart Failure: 2002–2013

Cited by 13 publications

References 28 publications

Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

Female sex reduces the risk of hospital-associated acute kidney injury: a meta-analysis

Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock

Contact Info

Product

Resources

About