Abstract: SA-PO052

Race and Post-Hospitalization Mortality in AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Owoyemi, Itunu O., University of Virginia, Charlottesville, Virginia, United States
  • Xin, Wenjun, University of Virginia, Charlottesville, Virginia, United States
  • Abdel-Rahman, Emaad M., University of Virginia, Charlottesville, Virginia, United States
  • Balogun, Rasheed A., University of Virginia, Charlottesville, Virginia, United States
Background

Acute Kidney Injury (AKI) , like ESRD, is known to be associated with increased mortality. Racial differences in outcomes exist in patients with multiple medical conditions and “access to care” is one of the linked variables. This study aims to determine if racial differences in mortality exists after hospital discharge for AKI when access to care may be inconsistent.

Methods

Retrospective cohort study of adults admitted to the University of Virginia Medical Center between January 1, 2001 and December 31, 2015 who had AKI during hospitalization. AKI definition of > 0.3 mg/dl rise in serum creatinine, SCr, within 48 hours was used (Kidney Disease Improving Global Outcomes, KDIGO).
Patients' characteristics or risk factors were summarized as frequencies and percentages for categorical variables and as mean ± standard deviation for continuous variables. The associations of these factors with the outcome of 90-day mortality post hospitalization were evaluated in logistic regression, measured by odds ratios (ORs) for the likelihood of post-hospitalization mortality. The 95% confidence intervals (CIs) for ORs and the corresponding p-values are reported. A p-value < 0.05 was considered to be statistically significant.

Results

We had a total of 11, 837 patients in our cohort with 79.7% whites and 17.8% blacks. Mean age was 62.41±15.52. Mean baseline SCr was 1.33±0.78 and mean Charlson index score of 4.13 ± 3.21. A total of 9808 were followed post hospital discharge while 1914 patients died in hospital and 88 patients did not have a last follow up date. A multivariate assessment adjusting for several co-morbidities showed a lower mortality rate at 90 days in black patients versus Caucasians.

Conclusion


Black patients with AKI had lower post-hospitalization 90-day mortality. This outcome is similar to that seen in black patients treated for ESRD in USA. A better understanding of mechanisms underlying a possible survival advantage in black Americans with AKI needs further investigation.