ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO010

Geographic Correlation Between Dialysis-Requiring AKI and Recovery from ESRD

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Chen, Zijin, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
  • Lee, Benjamin J., University of California San Francisco, San Francisco, California, United States
  • McCulloch, Charles E., University of California San Francisco, San Francisco, California, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States
  • Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States

Group or Team Name

  • CDC CKD Surveillance Team
Background

We recently reported that about 5% of incident end stage renal disease (ESRD) patients in the U.S. recover enough kidney function to discontinue maintenance dialysis (Lee AJKD 2017). Large geographic variations in rates of renal recovery among ESRD patients have also been reported (Mohan PLoS One 2013). We hypothesized that this may be related to variation in rates of dialysis-requiring acute kidney injury (AKI-D).

Methods

Incidence rates of AKI-D hospitalization in 2011 for AZ, AR, CA, FL, IA, KY, MA, MD, MI, NJ, NM, NY, NV, OR, RI, SC, VT and WA were calculated from the State Inpatient Database using validated diagnostic and procedure codes. Rates of renal recovery among ESRD patients in 2011 were calculated using U.S. Renal Data System data. U.S. Census data were used to define underlying population sizes. Correlation (unadjusted) was determined using Pearson’s r.

Results

We found a positive correlation between rate of renal recovery and incidence of AKI-D, both overall (Figure) and in subgroups (Table).

Conclusion

Rates of renal recovery among incident ESRD patients varied considerably across states and correlated with geographic variation in AKI-D incidence. These findings support the hypothesis that renal recovery among ESRD patients mostly represents recovery from AKI-D. When reporting counts of “end-stage” renal disease, subtracting those who recovered renal function (which ranges in magnitude from 3% to 8% in the sampled states) might be a consideration.

State-level correlation between AKI-D incidence and rate of renal recovery among ESRD patients stratified by age and sex
 Pearson Correlation rP
age 45 - 64 yrs0.630.005
age 65 - 74 yrs0.580.012
age ≥ 75 yrs0.690.001
Male0.680.002
Female0.580.012

Funding

  • NIDDK Support