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Kidney Week

Abstract: PO0014

AKI in the Emergency Department: A Prospective Case-Control Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Ragnarsdóttir, Telma Huld, Landspitali University Hospital, Reykjavik, Iceland
  • Kristjansdottir, Margret, Landspitali University Hospital, Reykjavik, Iceland
  • Gislason, Gisli, University of Iceland, Faculty of Medicine, Reykjavik, Iceland
  • Sanchez-Brunete, Vicente, Landspitali University Hospital, Reykjavik, Iceland
  • Tomasdottir, Margret Olafia, Primary Health Care of the Capital Area, Reykjavik, Iceland
  • Samuelsson, Olafur Helgi, Landspitali University Hospital, Reykjavik, Iceland
  • Palsson, Runolfur, Landspitali University Hospital, Reykjavik, Iceland
  • Indridason, Olafur S., Landspitali University Hospital, Reykjavik, Iceland
Background

Acute kidney injury (AKI) is an abrubt decline in kidney function that occurs in hours or days. AKI has been throughly studied in the hospital setting, however data on community-aquired AKI are scarce. The aim of this study was to investigate the incidence, causes and prognosis of patients presenting with AKI to the emergency department (ED).

Methods

This was a prospective case-control study in which serum creatinine (SCr) measurements of all patients presenting to the ED of Landspitali–The National University Hospital in Reykjavík were examined for the presence of AKI. The study started on January 1, 2020, and we present data until March 3, 2020. All patients who met the criteria for AKI were invited to participate. Randomly selected control cases (1:2) were paired according to age, sex and time of ED admission. Participants signed informed consent and were questioned about their medical history, habits and use of medications, including over-the-counter (OTC) medications and supplements, in the week prior to admission. Medical records were also reviewed with regard to prior diseases and medical prescriptions.

Results

From January 1 to March 3, 124 cases of AKI were identified among patients presenting to the the ED, 114 (92%) of whom participated in the study. The mean (±SD) age of the 114 AKI cases and the 228 controls was 68.7±15.2 years and 68,8±15.0 years, respectively; 43% of cases and controls were female. AKI cases were significantly more likely than controls to have been taking non-steroidal anti-inflammatory drugs (NSAIDs) (36,0% vs 20,6%, p<0,01) in the week preceding the ED visit. In both cases and controls, the usage of OTC NSAIDs was more common than prescription NSAIDs (72.2% and 66.0%). No significant difference was observed between AKI cases and controls in use of ACE-inhibitors/angiotensin receptor blockers (45.6% vs 39.9%, p=0.314). The use of proton pump inhibitors was less common among AKI cases than controls (27.2% vs 41.7% , p<0.01) and same was true for statins (22.8% vs 33.3%, p=0.045).

Conclusion

These preliminary results suggest a significant contribution of OTC NSAID use to AKI among patients presenting to the ED. A detailed information on adverse events should be provided when these medications are sold over the counter.

Funding

  • Government Support - Non-U.S.