Abstract: FR-PO060

A 10-Year National Trend in Dialysis-Requiring AKI among Hospitalized Adults with HIV Infection

Session Information

  • AKI Clinical: Predictors
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Wen, Yumeng, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Pan, Di, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Mariuma, David, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Hernandez cuchillas, Marcelo Xavier, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Luo, Yiming, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Gramuglia, Michael, Montefiore Medical Center, Scarsdale, New York, United States
  • Meisels, Ira S., Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
Background

Patients with HIV are at risk for both acute kidney injury (AKI) and chronic kidney disease (CKD). Previous studies demonstrated an increasing incidence of AKI among HIV population. The aim of this study is to observe beyond the time frame of the previous studies and to explore the in-hospital mortality and other outcomes among hospitalized HIV patients who developed dialysis-requiring AKI between 2005 and 2014.

Methods

This is a retrospective study using the 2005-2014 National Inpatient Sample, the largest inpatient database in the US. A cohort of 2,133,610 patients over the age of 18 diagnosed with HIV based on ICD-9 CM codes was included in this study. Patients hospitalized for elective procedures were excluded. In the primary analysis, we examined the temporal trend in the incidence of dialysis-requiring AKI. In the secondary analysis, we examined temporal changes in in-hospital mortality, length of stay, and total charges in hospitalizations complicated by dialysis-requiring AKI. Odds ratios (OR) were calculated based on multivariate logistic analyses, adjusted for demographics, related comorbidities and procedures. Analysis was performed using Stata 14.2.

Results

There was an increasing incidence of dialysis-requiring AKI among the HIV population over time (1.03% in 2005 vs 1.49% in 2014). Among HIV patients developing dialysis-requiring AKI, the in-hospital mortality rates decreased over time (25.35% in 2005 vs 18.79% in 2014, OR 0.93, p<0.001). The length of hospital stay had a increasing trend after initial decline (18.62 days in 2005 vs 15.62 days in 2011 vs 17.03 days in 2014, p=0.016). There was also a increase in total hospital charges ($122,273 in 2005 vs. $188,613 in 2014, p<0.001). Hospitalizations complicated by dialysis-requiring AKI compared to those that were not were associated with higher in-hospital mortality (OR 1.64, p<0.001)

Conclusion

This study demonstrates that despite an increase in incidence of dialysis-requiring AKI among patients with HIV, the in-hospital mortality of these patients has improved over time. The development of dialysis-requiring AKI continues to have significant life-altering impact and financial burden on HIV patients within our health-care system.