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Abstract: TH-PO074

Burden and In-Hospital Mortality of Dialysis-Requiring AKI (AKI-D) Among Hospitalized Adults with Granulomatosis with Polyangiitis (GPA)

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Boonpheng, Boonphiphop, East Tennessee State University, Johnson City, Tennessee, United States
  • Brooks, Billy, East Tennessee State University, Johnson City, Tennessee, United States
  • Sankhyan, Pratyaksha, East Tennessee State University, Johnson City, Tennessee, United States
  • Moore, William Scott, Mountain Home VA Medical Center, Mountain Home, Tennessee, United States
Background

To describe the incidence of acute kidney injury (AKI) requiring renal replacement therapy (dialysis-requiring AKI, AKI-D) and the impact on in-hospital mortality among hospitalized adults with granulomatosis with polyangiitis (GPA).

Methods

We reviewed the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) Database, a large nationally representative sample of inpatient hospital admissions, to identify all adult hospitalizations with AKI-D and primary or secondary diagnosis of granulomatosis with polyangiitis (GPA) from 2004–2014. We investigated the trend of AKI-D in each disease for each year and performed multivariate logistic regression to evaluate the impact of AKI-D and co-morbidities on in-hospital mortality.

Results

Among 339,856 hospitalizations with AKI-D, the proportion of GPA as an associated diagnosis remained stable at 0.31-0.47% per year. From 2004-2014, AKI-D complicated 0.32% of hospitalizations with GPA as a primary or secondary diagnosis. The age-adjusted odds of in-hospital mortality associated with AKI-D in patients with GPA decreased over the study period, from 0.92 (95% CI 0.88–0.96) in 2008 to 0.79 (95% CI 0.75–0.82) in 2014. Compared to other causes of AKI-D, GPA was significantly associated with lower in-hospital mortality with adjusted OR 0.64 (95% CI 0.55 - 0.76).

Conclusion

These data suggest that the incidence of dialysis-requiring AKI among hospitalized adults with GPA remained stable; however, the in-hospital mortality seemed to decrease and significantly lower than other causes of severe acute kidney injury.