Kidney Week

Abstract: SA-OR011

Pregnancy-Related AKI and Diabetes: Hospitalizations and Clinical Outcomes

Session Information

• AKI: Risk Factors, Biomarkers, and Predictors
  November 09, 2019 | Location: Salon C, Walter E. Washington Convention Center
  Abstract Time: 04:30 PM - 04:42 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States

Silvi Shah, MD, MS, FASN



Silvi Shah, MD, MS is an assistant professor in the Division of Nephrology and Hypertension at the University of Cincinnati, Ohio. After completing her residency in Internal Medicine at University at Buffalo (SUNY), she completed her general nephrology fellowship from Cleveland Clinic Foundation, Ohio followed by a transplant nephrology fellowship at the University of Alabama in Birmingham and masters in clinical and translational research at the University of Cincinnati. Dr. Shah’s research interests focus on women’s health in kidney disease including pregnancy, disparities in kidney disease, cardiovascular health in kidney disease, and innovative education tools in nephrology. She is currently involved in investigator-initiated clinical and translational research studies and national clinical trials. Dr. Shah has authored several peer-reviewed manuscripts and has presented at various premier international and national meetings. She is a peer reviewer for journals like JAMA, Transplantation and the American Journal of Kidney Disease. Dr. Shah leads the American Society of Nephrology’s “Women’s Health and Research in Nephrology” community and is an executive member of the American Society of Transplantation’s “Young Faculty Community of Practice”. She currently serves as a councilor in Women in Nephrology and in the American Society of Nephrology’s media and communication committee. She is a fellow of the American Society of Nephrology and the American College of Physicians. Dr. Shah also has a keen interest in the use of social media in medical education. She currently serves as a faculty member in the Nephrology Social Media Collective, and NephJC (online nephrology journal club). She enjoys teaching and mentoring medical students, residents, and fellows. Please contact Dr. Shah at shah2sv@ucmail.uc.edu. Follow her on twitter @silvishah

• Meganathan, Karthikeyan, University of Cincinnati, Cincinnati, Ohio, United States

Karthikeyan Meganathan,

• Leonard, Anthony C., University of Cincinnati, Cincinnati, Ohio, United States

Anthony C. Leonard,

• Christianson, Annette, Cincinnati VA, Cincinnati, Ohio, United States

Annette Christianson,

• Thakar, Charuhas V., University of Cincinnati, Cincinnati, Ohio, United States

Charuhas V. Thakar,

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.