Abstract 20484: National Trends and Outcomes in Dialysis-requiring Acute Kidney Injury in patients With Congestive Heart Failure: 2002-2013
Background: Acute kidney injury requiring dialysis (AKI-D) is a serious and preventable complication in patients admitted with Congestive Heart Failure (CHF). However, data on national trends in AKI-D after CHF are lacking after 2002.
Methods: We used the Nationwide Inpatient Sample (NIS) database for the period of 2002-2013 to identify adults hospitalized with CHF using ICD-9-CM diagnosis codes 428.xx and 398.91. We defined AKI-D based on previously validated ICD-9-CM codes including 584.xx for AKI, v45.11, v56.0 and v56.1 for dialysis and procedure code 39.95 for the dialysis procedure. We excluded hospitalizations that had codes for dialysis but not for AKI, as these were likely for ESRD patients on dialysis. We used the multivariate regression to analyze changes in trends and outcomes, such as mortality and discharge to specialized care facilities.
Results: From 2002-2013, of the 11,112,666 hospitalizations for CHF, 93,076 (0.83%) developed AKI-D. The proportion of AKI-D increased from 0.51% of CHF hospitalizations in 2002 to 1.09% of these hospitalizations in 2013 (p<0.001) (Figure 1). There was an annual increase of 7.1% (OR: 1.07; 95% CI: 1.07-1.08; p<0.001). Percentage of in-hospital mortality (19% vs 3.5%) and discharge to specialized care (40% vs 23%) were higher among the AKI-D patients. Odds of in-hospital mortality (OR: 2.49; 95% CI: 2.36-2.63; p<0.001) and discharge to specialized care (OR: 2.04; 95% CI: 1.95-2.13; p<0.001) among patients with AKI-D were higher than those of patients without AKI-D, even after adjusting the various confounding factors related to the study.
Conclusions: The incidence of AKI-D in patients admitted with CHF has nearly doubled between 2002 and 2013. Also, those who developed AKI-D had over twice the odds of in-hospital mortality and discharge to specialized care compared to those who didn’t. Our results emphasize the need for early recognition of kidney dysfunction in patients with CHF in order to prevent this complication.
Author Disclosures: A. Correa: None. H. Shah: None. A. Mishra: None. M. Dave: None. A. Patel: None. T. Mishra: None. M. Elnazeir: None. N. Kallakuri: None. K. Chauhan: None. S. Khicher: None. D.D. Stapleton: None. G. Nadkarni: None.
- © 2016 by American Heart Association, Inc.