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Abstract: PO0025

Relationship of Loop Diuretic with Hospital-Acquired AKI: A Multicenter, Propensity Score-Matching Analysis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Li, Yanqin, Nanfang Hospital of Southern Medical University, Nephrology Guangzhou, China; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research, Guangzhou, China
  • Su, Licong, Nanfang Hospital of Southern Medical University, Nephrology Guangzhou, China; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research, Guangzhou, China
  • Xu, Xin, Nanfang Hospital of Southern Medical University, Nephrology Guangzhou, China; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research, Guangzhou, China
Background

Loop diuretics have been widely used to prevent and treat acute kidney injury (AKI). However, there is no clear consensus on the role of loop diuretics in AKI.

Methods

The Epidemiology of AKI in Chinese Hospitalized patients is a multicenter retrospective cohort included 3,044,024 hospitalized patients from 25 tertiary hospitals across China during 2013-2015. Patient data were obtained from the electronic hospitalization information system. We selected 57589 adult patients who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization and excluded those with end-stage renal disease, community-acquired AKI and without prescription data. AKI was defined using the SCr data by the Kidney Disease Improving Global Outcomes criteria. Exposure to Loop diuretics as any filled prescription within 14 days prior to the detection date of AKI in patients with HA-AKI and within 14 days prior to the last SCr testing date in those without AKI. Propensity scores (PS) were calculated using a logistic regression model with age, gender, hospital, division, baseline SCr, SCr testing times, comorbidities, operation procedures, need for intensive care and exposure to other nephrotoxic drugs. Moreover, the inverse probability of the treatment weighting (IPTW) method and standardized mortality ratio weighting method was also used.

Results

Of 57589 adult analysed, 20599 (35.8%) used diuretics, 17077 (29.7%) used loop diuretics, and 6277 (10.9%) had HA-AKI events during hospitalization. 8,274 pairs matched after nearest-neighbor matching without replacement and within caliper width (0.2*SD of the logit of PS). By IPTW, use of loop diuretics was associated with a significantly increased risk of HA-AKI compared with non-users (OR, 1.39; 95% CI, 1.28-1.52). The associations were consistent across multiple regression models.

Conclusion

Loop diuretics were widely used and associated with an increased risk of HA-AKI in hospitalized adult in China.

Funding

  • Government Support - Non-U.S.