Abstract: TH-PO1143
Acute Pancreatitis (AP) in CKD5 and Kidney Transplant (Tx) Recipients: Results of a US Nationwide Analysis
Session Information
- CKD: Clinical, Outcomes, Trials - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kroner, Paul T., Mayo Clinic, Jacksonville, Florida, United States
- Raimondo, Massimo, Mayo Clinic, Jacksonville, Florida, United States
- Mareth, Karl, Mayo Clinic, Jacksonville, Florida, United States
- Alsaad, Ali, Mayo Clinic, Jacksonville, Florida, United States
- Aslam, Nabeel, Mayo Clinic, Jacksonville, Florida, United States
- Wadei, Hani, Mayo Clinic, Jacksonville, Florida, United States
Background
The prevalence of AP in CKD5 has not been clearly defined. The aim of this study was to compare the prevalence, etiology and outcomes of AP in CKD5 and kidney tx recipients with those without CKD using a large national database
Methods
Using the Nationwide Inpatient Sample (NIS) database,433,805 patients hospitalized in 2014 with ICD-9 admission code for AP were identified. All patients were >18 yrs old and had no history of pancreas tx. Patients with AP and CKD5 not on dialysis (n=690), CKD5 on dialysis (n=11,415) and kidney tx recipients (n=1,320) were identified and were propensity-matched in a 1:1 fashion and regressed against gender, age, ethnicity and Charlson Comorbidity Index to patients with AP and no CKD (n=13,425). A multivariate logistic regression was constructed to adjust for other variables such as patients' median income, hospital region, hospital size and teaching status
Results
Results are presented in Table 1. Adjusted prevalence of AP was comparable between the non-CKD, CKD5, and kidney tx populations. Crude and adjusted mortality was higher in CKD5 and kidney tx patients. CKD5 patients were more likely to develop shock and require ICU than the non-CKD group. Alcoholic and gall stone AP were more common in non-CKD group while hypercalcemia AP was more common in the CKD5 group
Conclusion
1)The adjusted prevalence of AP is comparable between non-CKD patients, CKD5 and kidney tx recipients. 2)Adjusted mortality is more than double in CKD5 and kidney tx recipients comapred to non-CKD patients. 3)Dialysis-dependent CKD5 patients hospitalized with AP had highest rate of shock and ICU stay compared to non-CKD patients. 4)Hypercalcemia is the main cause of AP in the CKD5 population irrespective of dialysis need
Prevalence, mortality and etiology of AP in patients without CKD, with CKD5 and in kidney tx recipients
| No CKD (n=13,425) | CKD5 no dialysis (n=690) | CKD5 with dialysis (n=11,415) | Kidney Tx (n=1,320) | |
| Unadjusted AP prevalence (per 1,000 persons) | 11.4 | 11.3 | 12.7 | 14.8 (P<0.01 between groups) |
| Adjusted OR of AP (95% CI) | Ref. | 1.15 (0.8-1.6) P=0.4 | 1.01 (0.9-1.1) P=0.4 | 0.9 (0.7-1.1) P=0.3 |
| Unadjusted inpatient mortality | 1.8% | 4.5% | 5.6% | 3.3% (P<0.01 between groups) |
| Adjusted inpatient mortality | Ref. | 2.13 (0.9-4.9) P=0.08 | 2.72 (2.2-3.3) P<0.01 | 2.29 (1.1-4.5) P=0.02 |
| Shock | Ref. | 0.78 (0.3-1.7) P=0.5 | 1.53 (1.4-1.7) P<0.01 | 1.1 (0.6-1.9) P=0.7 |
| ICU admission | Ref. | 0.63 (0.3-1.3) P=0.2 | 1.32 (1.1-1.5) P<0.01 | 0.82 (0.5-1.4) P=0.5 |
| Hypercalcemia | Ref. | 4.26 (1.9-9.7) P<0.01 | 1.52 (1.1-2.8) P=0.02 | 1.68 (0.7-4.1) P=0.2 |
| Gall stone | Ref. | 1.09 (0.7-1.6) P=0.7 | 0.8 (0.7-1.0) P=0.01 | 0.57 (0.4-0.8) P<0.01 |
| Alcohol | Ref. | 0.48 (0.3-0.8), P=0.01 | 0.22 (0.2-0.3) P<0.01 | 0.10 (0.05-0.2) P<0.01 |