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Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016; 5(3):e002739JA

Abstract

BACKGROUND

Acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) are common, serious complications of cardiac procedures.

METHODS AND RESULTS

We evaluated 3 633 762 (17 765 214 weighted population) cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. Odds ratios for both conditions and associated in-hospital mortality were calculated for each year in the study period using multiple logistic regression. The number of cardiac catheterization or PCI cases resulting in AKI rose almost 3-fold from 2001 to 2011. The adjusted odds of AKI and AKI-D per year among cardiac catheterization and PCI patients were 1.11 (95% CI: 1.10-1.12) and 1.01 (95% CI: 0.99-1.02), respectively. Most importantly, in-hospital mortality significantly decreased from 2001 to 2011 for AKI (19.6-9.2%) and AKI-D (28.3-19.9%), whereas odds of associated in-hospital mortality were 0.50 (95% CI: 0.45-0.56) and 0.70 (95% CI: 0.55-0.93) in 2011 versus 2001, respectively. The population-attributable risk of mortality for AKI and AKI-D was 25.8% and 3.8% in 2001 and 41.1% and 6.5% in 2011, respectively. Males and females had similar patterns of AKI increase, although males outpaced females.

CONCLUSIONS

The Incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States, and this should be addressed by implementing prevention strategies. However, mortality has significantly declined, suggesting that efforts to manage AKI and AKI-D after cardiac catheterization and PCI have reduced mortality.

Authors+Show Affiliations

The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, NH Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH jbrown@dartmouth.edu.The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, NH Oakland University William Beaumont School of Medicine, Rochester, MI.The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, NH.The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, NH.Geriatrics Research Education & Clinical Center (GRECC), Tennessee Valley Healthcare System (TVHS), Veteran's Health Administration, Murfreesboro, TN Division of Nephrology, Department of Medicine, Vanderbilt Center for Kidney Disease (VKCD), Vanderbilt University School of Medicine, Nashville, TN.Geriatrics Research Education & Clinical Center (GRECC), Tennessee Valley Healthcare System (TVHS), Veteran's Health Administration, Murfreesboro, TN Division of General Internal Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

27068629

Citation

Brown, Jeremiah R., et al. "Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample." Journal of the American Heart Association, vol. 5, no. 3, 2016, pp. e002739.
Brown JR, Rezaee ME, Nichols EL, et al. Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample. J Am Heart Assoc. 2016;5(3):e002739.
Brown, J. R., Rezaee, M. E., Nichols, E. L., Marshall, E. J., Siew, E. D., & Matheny, M. E. (2016). Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample. Journal of the American Heart Association, 5(3), pp. e002739. doi:10.1161/JAHA.115.002739.
Brown JR, et al. Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample. J Am Heart Assoc. 2016 Mar 15;5(3):e002739. PubMed PMID: 27068629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample. AU - Brown,Jeremiah R, AU - Rezaee,Michael E, AU - Nichols,Elizabeth L, AU - Marshall,Emily J, AU - Siew,Edward D, AU - Matheny,Michael E, Y1 - 2016/03/15/ PY - 2016/4/13/entrez PY - 2016/4/14/pubmed PY - 2016/12/15/medline KW - acute kidney injury KW - acute renal failure KW - glomerular filtration rate KW - renal failure SP - e002739 EP - e002739 JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 5 IS - 3 N2 - BACKGROUND: Acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) are common, serious complications of cardiac procedures. METHODS AND RESULTS: We evaluated 3 633 762 (17 765 214 weighted population) cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. Odds ratios for both conditions and associated in-hospital mortality were calculated for each year in the study period using multiple logistic regression. The number of cardiac catheterization or PCI cases resulting in AKI rose almost 3-fold from 2001 to 2011. The adjusted odds of AKI and AKI-D per year among cardiac catheterization and PCI patients were 1.11 (95% CI: 1.10-1.12) and 1.01 (95% CI: 0.99-1.02), respectively. Most importantly, in-hospital mortality significantly decreased from 2001 to 2011 for AKI (19.6-9.2%) and AKI-D (28.3-19.9%), whereas odds of associated in-hospital mortality were 0.50 (95% CI: 0.45-0.56) and 0.70 (95% CI: 0.55-0.93) in 2011 versus 2001, respectively. The population-attributable risk of mortality for AKI and AKI-D was 25.8% and 3.8% in 2001 and 41.1% and 6.5% in 2011, respectively. Males and females had similar patterns of AKI increase, although males outpaced females. CONCLUSIONS: The Incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States, and this should be addressed by implementing prevention strategies. However, mortality has significantly declined, suggesting that efforts to manage AKI and AKI-D after cardiac catheterization and PCI have reduced mortality. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/27068629/Incidence_and_In_Hospital_Mortality_of_Acute_Kidney_Injury__AKI__and_Dialysis_Requiring_AKI__AKI_D__After_Cardiac_Catheterization_in_the_National_Inpatient_Sample_ L2 - http://www.ahajournals.org/doi/full/10.1161/JAHA.115.002739?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -