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Kidney Week

Abstract: SA-OR011

Pregnancy-Related AKI and Diabetes: Hospitalizations and Clinical Outcomes

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
  • Meganathan, Karthikeyan, University of Cincinnati, Cincinnati, Ohio, United States
  • Leonard, Anthony C., University of Cincinnati, Cincinnati, Ohio, United States
  • Christianson, Annette, Cincinnati VA, Cincinnati, Ohio, United States
  • Thakar, Charuhas V., University of Cincinnati, Cincinnati, Ohio, United States
Background


Pregnancy-related acute kidney injury (AKI) is a public health problem and is associated with significant maternal and fetal morbidity and mortality. Clinical outcomes in pregnancy-related AKI, especially in women with diabetes are not well studied.

Methods

Using data from the 2012-2015 Nationwide Inpatient Sample, we identified hospitalizations for pregnancy, acute kidney injury (AKI), and diabetes mellitus using ICD-9-CM and DRG codes in women aged 15-49 years. We compared AKI rates, mortality, and home discharge rates in pregnancy-related AKI in women according to their diabetic status.

Results

We identified 15,550,459 pregnancy-hospitalizations in the study cohort. Rate of pregnancy-related hospitalization involving AKI was 0.1% and increased from 0.09% in 2012 to 0.12% in 2015. Women with pregnancy-related AKI were older than those who did not develop AKI (mean age, 40y vs. 30 y). Pregnancy-related AKI occurred at a higher rate in black women (0.25%) than white women (0.07%, p<0.0001) and at a higher rate in southern and midwest geographical regions (0.12%) than in northeast region (0.09%, p<0.0001). Higher rate of pregnancy-related AKI was observed in urban teaching hospitals (0.14%) than in urban non-teaching hospitals (0.07%) and rural hospitals (0.04%, p<0.0001). Women with pregnancy-related AKI had higher in-hospital mortality than those without AKI (2.6% vs. 0.01%). Overall, 1.3% of women were diabetic. Women with diabetes had higher pregnancy-related AKI hospitalizations than did women without diabetes (1.1% vs. 0.1%). Rate of pregnancy-related hospitalization involving AKI in diabetic women increased from 0.9% in 2012 to 1.2% in 2015. Diabetic women with pregnancy-related AKI did not differ with in-patient hospital mortality compared to pregnancy-related AKI in women without diabetes (3.2% vs. 2.5%) and with discharge to home (76% vs 78%).

Conclusion

Rate of pregnancy-related hospitalization involving AKI has increased overall and in diabetic women. In-hospital mortality is 260-fold higher in women with pregnancy-related AKI than those with no AKI. Women with diabetes have a 10-fold higher risk of AKI during pregnancy than those without diabetes but are not associated with a higher risk of mortality.