Abstract: SA-PO010

Differential Trends in Incident Rates of AKI by Severity Stage in the Irish Health System

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Browne, Leonard, University of Limerick, Limerick, Ireland
  • Mohamed ALi, Alaa Mohamed Alamin Abdelrahim, University Hospital Limerick, Limerick, Ireland
  • Aruna udayakumar, Arunkumar, University Of Limerick, Limerick, Ireland
  • Hussein, Wael F., Limerick University Hospital, Limerick, Ireland
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Stack, Austin G., Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Group or Team Name

  • UL Kidney Consortium
Background

Surveillance of Acute Kidney Injury (AKI) is a fundamental component of prevention strategies in health systems in order to reduce adverse outcomes. Recent studies have shown rising incident trends for dialysis-requiring AKI. We determined incident rates of first AKI by stage from 2005-2014 in the Irish Health System

Methods

We utilised data from the National Kidney Disease Surveillance System in Ireland to explore trends in incident AKI within the health system from 2005 to 2014 (n= 453, 509). AKI events were identified per KDIGO guidelines and classified by stage (1 to 3) and incidence rates per 100 patients were calculated for each year. Multivariable logistic models explored the relationship of calendar year with AKI incidence expressed as odds ratio (OR) and 95% Confidence Intervals (CI) with adjustment for age, sex, county of residence, location of medical supervision and laboratory indicators of health.

Results

From 2005 to 2014, incidence rates of AKI per 100 patients increased from 5.5 % (5.4, 5.7) to 11.8 % (11.4, 12.1) in Stage 1; 0.58 % (0.53, 0.63) to 1.32 % (1.19, 1.45) in Stage 2, and from 0.46 % (0.41, 0.51) to 0.71 % (0.61, 0.81) in Stage 3. With adjustment for age, sex and baseline eGFR, a pattern of increasing odds of AKI was observed across all 3 stages (P<0.001 for trend).With further adjustment for county of residence, hospital, location of medical supervision and laboratory health indicators, a rising trend in incidence was observed only AKI Stage 1, while the reverse was seen for AKI Stage 2 and 3 (Figure 1), all P<0.001.

Conclusion

Increasing incidence of Stage 1 AKI is primarily responsible for overall growth of AKI in the Irish Health System. Accounting for changing demographic, clinical and geographic profiles, incident rates of Stage 2 and Stage 3 AKI have fallen in recent years and suggest improved preventive strategies.