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Kidney Week

Abstract: TH-PO092

Characteristics and Outcomes of Hospitalized Homeless AKI Patients

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Klomjit, Nattawat, Mayo Clinic, Rochester, Minnesota, United States
  • Sy-Go, Janina Paula Tiulentino, University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii, United States
  • Ng, Roland C.K., University of Hawaii Internal Medicine Residency Program, Honolulu, Hawaii, United States
Background

Hawaii has the highest rate of homeless population per capita. Homeless people are a vulnerable group and prone to multiple health problems, including kidney diseases. Little is known about the characteristics and outcomes of acute kidney injury (AKI) in this population.

Methods

This is a retrospective study of homeless and domiciled patients who were admitted to a tertiary medical center in Honolulu, Hawaii between 2015-2016, with AKI diagnosis present on admission by ICD10 code and meeting 2012 KDIGO criteria for AKI.

Results

Between 2015 and 2016, we identified 324 patients who were admitted with AKI of which 6.48 % were homeless. Mean age of homeless patients was 56.9±8.75 compared to domiciled patients 65.85±17.59 with p<0.01. Homeless patients tended to be female (80.85%) compared to domiciled patients (52.81%), p<0.01. Caucasian race was a majority of the homeless patients, 47.62%, compared to 21.45% in domiciled patients. 71.43% of the homeless patients had a pre-renal cause of AKI compared to 38.61% in domiciled patients, p=0.06. There was no difference in percentage of underlying chronic kidney disease between homeless and domiciled patients, p=0.89. 38.10% of homeless patients visited the emergency room within 1 month prior to an index admission compared to 17.49% in domiciled patients, p=0.02. Homeless patients were more likely to be a substance user, current smoker, and alcohol abuser compared to domiciled patients, all p<0.01. Homeless patients were more likely to be discharged with a lower serum creatinine, p<0.01, and significantly shorter hospital stay, p=0.04.

Conclusion

Homeless AKI patients tended to be younger, more likely a substance user, current smoker, alcohol abuser, and with liver disease than domiciled patients. Caucasian race was the majority of homeless patients, whereas Asian race was the majority of domiciled patients. Although pre-renal cause was the most common cause of AKI in both groups, the rate of pre-renal cause in homeless patients was almost twice that of domiciled patients. There was no difference in admission serum creatinine, but the homeless were discharged with lower serum creatinine likely due to a higher rate of reversible kidney injury. There was no difference in mortality or dialysis rate.