Abstract: FR-PO088
Community-Acquired AKI: A Prospective Case-Control Study
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - I
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Ragnarsdóttir, Telma Huld, Landspitali, Reykjavik, Iceland
- Kristjansdottir, Margret, Landspitali, Reykjavik, Capital, Iceland
- Gislason, Gisli, Landspitali, Reykjavik, Iceland
- Tomasdottir, Margret Olafia, Heilbrigdisvisindasvid - Haskoli Island, Reykjavik, Iceland
- Sanchez-Brunete, Vicente, Landspitali, Reykjavik, Capital, Iceland
- Samuelsson, Olafur Helgi, Landspitali, Reykjavik, Capital, Iceland
- Palsson, Runolfur, Landspitali, Reykjavik, Iceland
- Indridason, Olafur S., Landspitali, Reykjavik, Capital, Iceland
Background
Acute kidney injury (AKI) is a common clinical entity in the hospital setting but data on community-acquired AKI is lacking. The aim of this study was to examine the causes and risk factors for community acquired AKI.
Methods
This was a prospective case-control study in which serum creatinine (SCr) of all individuals admitted to the emergency department (ED) of Landspitali–The National University Hospital of Iceland were examined for the presence of AKI. We present data from January 1 until March 3, 2020, May 19 until September 21, 2020, and February 1 until June 15, 2021. The study was paused between these periods due to the COVID-19 pandemic. Patients who met the SCr component of the KDIGO criteria for AKI were invited to participate. Randomly selected control cases (1:2) were paired according to age, sex, and date of ED visit. Participants answered questions about their medical history and use of medications, including over the counter (OTC) drugs. Past medical history was obtained from electronic medical records. Conditional logistic regression was used to identify factors associated with AKI.
Results
A total of 602 AKI cases were identified in 574 persons during the study period, 488 of whom participated (512 cases). The mean (±SD) age of AKI cases and controls was 67.1±16.6 years and 67.2 ±16.2 years, respectively; 48% of cases and controls were female. AKI cases were significantly more likely than controls to have used non-steroidal anti-inflammatory drugs (NSAID) (26.0% vs 18.0%, p=0,001) in the week preceding the ED visit, particularly OTC NSAID (23.3% vs 15.9%, p<0.001). In adjusted analysis, AKI was associated with vomiting (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.95-3.53), diarrhea (OR 1.35, 95% CI 1.04-1.75), urinary retention (OR 1.86, 95% CI 1.32-2.62) and use of NSAID (OR 1.60, 95% CI 1.18-2.23), diuretics (OR 1.48, 95% CI 1.12-1.99) or ACEi/ARB (OR 1.49, 95% CI 1.12-1.99). A statistically significant relationship was not observed for diabetes, hypertension, vascular- or chronic kidney disease.
Conclusion
Volume depletion and the use of NSAID and ACEi/ARB seem to play a major role in the development of AKI in the community setting. Use of OTC NSAID is surprisingly frequent and should be addressed considering serious adverse effects.
Funding
- Government Support – Non-U.S.