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Kidney Week

Abstract: TH-PO509

Longitudinal Trends in Pediatric Hospitalizations Complicated by AKI in the United States

Session Information

  • Pediatric Nephrology - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Kula, Alexander J., Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Menon, Shina, Seattle Children's Hospital, Seattle, Washington, United States
Background

There are limited national data describing longitudinal trends of pediatric acute kidney injury (AKI) and AKI requiring dialysis (AKI-D) We aimed to characterize rates of pediatric AKI and AKI-D across the United States over a 20-year period.

Methods

We analyzed data from the Kids Inpatient Database (KID) from 1997 to 2016. AKI was identified using International Classification of Diseases Clinical Modification (ICD-CM) codes, 9th Revision (1997-2012) and 10th Revision (2016). Use of dialysis during hospitalization was assessed using procedure codes. We excluded pediatric hospitalization for uncomplicated, term newborn birth. Weighted data was used to estimate national yearly incidence totals and rates.

Results

Over the study period, there was a weighted total of 49,228,048 pediatric discharges, 22,059,242 of which were included in the final analysis. Nationwide, the yearly incidence of AKI and AKI-D increased from 1997 (AKI: 8340 cases/year, AKI-D: 1049 cases/year) to 2016 (AKI: 43,053 cases/year, AKI-D: 1656 cases/year). The rates of hospitalizations with AKI and AKI-D also increased from 1997 (cases/10k discharges [95%CI]: AKI: 20.7 [20.2, 21.1], AKI-D: 2.6 [2.4,2.8]) to 2016 (AKI: 111 [110, 112], AKI-D: 4.2 [4.0, 4.5]) (Figure 1).

Conclusion

This analysis of KID shows an increase in the absolute number, and the rate of pediatric hospitalizations complicated by AKI and AKI-D 1997 to 2016. While some of the increase may be explained by an increase in awareness and documentation, there is a near 3-fold increase in rates of AKI-D. More detailed analysis are needed to evaluate the reasons behind this. Given our understanding of the long-term impact of AKI, it is important to assess for preventable causes and to optimize care of those with AKI and AKI-D.