Abstract: FR-PO112

Incidence and Risk Factors of AKI in the General Population

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Jonsson, Arnar Jan, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
  • Indridason, Olafur S., Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
  • Lund, Sigrun Helga, University of Iceland, Reykjavík, Iceland
  • Palsson, Runolfur, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
Background

Acute kidney injury (AKI) in the setting of acute illness or major surgery is well described. Little is known about the burden of AKI in the general population. The purpose of this study was to estimate the incidence and risk factors for AKI in the Icelandic general population.

Methods

In this retrospective study, we obtained all serum creatinine (SCr) values from all clinical laboratories in Iceland for the years, 2008-2013. Data on age, gender, diagnoses of comorbid conditions and HbA1c values were retrieved from electronic medical records. Using computerized algorithms, we identified episodes of AKI defined according to the KDIGO criteria as a rise in SCr of ≥0.3 mg/dL over 48 hours and/or ≥50% from baseline over 7 days. CKD was defined and staged according to the KDIGO classification system. Chi-squared test and Students T-test were used to compare groups. Age-adjusted incidence was calculated for men and women and stratified by age groups and standardized to the EU27 population.

Results

We obtained 1,230,563 SCr values for 183,931 individuals aged ≥18 years. The median age was 62 years and 47.5% were men. For individuals with AKI, 19.1% had hypertension, 14.8% had diabetes, 19.5% had coronary artery disease and 10.5% had CKD compared with 6.7%, 5.3%, 5.8% and 1.2% for individuals without AKI, respectively (p<0.001 all variables). For men, the annual age-adjusted incidence of AKI was 1124/100,000 for stage 1, 57.7/100,000 for stage 2 and 18.1/100,000 for stage 3 AKI. In women, the annual age-adjusted incidence was 1349/100,000 for AKI stage 1, 62/100,000 for stage 2 and 21/100,000 for stage 3 AKI with significant difference between sexes (p<0.05). The incidence of AKI stages 1-3 rose with advancing age; it was 111/100.000, 329/100.000, 1076/100.000, 1984/100.000 and 3470/100.000 for the age groups 20-44 years, 45-64 years, 65-74 years, 74-85 years, and ≥85 years, respectively. Age-adjusted incidence of AKI stages 1-3 increased during the study period with RR of 1.026 (95%CI, 1.017-1.035) for each year.

Conclusion

This nationwide study shows a steep rise in the incidence of AKI with advancing age. Individuals who developed AKI had an increased prevalence of comorbid conditions, suggesting the need for caution in these groups of patients.

Funding

  • Government Support - Non-U.S.