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Kidney Week

Abstract: SA-PO0034

Burden of AKI in Hematopoietic Stem-Cell Transplant Recipients: A Retrospective National Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Mathew, Tijin A, Southeast Health, Dothan, Alabama, United States
  • Jiby, Sandhra, Dr Somervell Memorial CSI Medical College and Hospital, Thiruvananthapuram, KL, India
  • George, Lydia, Southeast Health, Dothan, Alabama, United States
  • Easow, Benjamin M., Southeast Health, Dothan, Alabama, United States
  • Thomas, Greeshma A., Southeast Health, Dothan, Alabama, United States
  • Siddiqui, Nabeel, Southeast Health, Dothan, Alabama, United States
  • Koduru, Beulah Jyothy, Southeast Health, Dothan, Alabama, United States
Background

Acute kidney injury (AKI) is a frequent and serious complication following hematopoietic stem cell transplantation (HSCT), and the incidence rate is considered to be 10% to 73%, depending on the type of transplant and conditioning regimen. The study aims to identify the epidemiological disparities and mortality outcomes of patients undergoing hematopoietic stem cell transplant with and without AKI.

Methods

We conducted a retrospective analysis using the 2022 National Inpatient Sample (NIS) database, utilizing STATA 18 to identify HSCT patients' hospital admissions with and without AKI. We employed a T-test to compare the mean age, length of stay, and total charges between the two groups.

Results

In 2022, there were a total of 4112 hospital admissions with HSCT. Among these patients, 1013 developed AKI. The occurrence of AKI in HSCT was more prevalent in older patients with a mean age of 60 years and a p-value of 0.01. The mean length of stay and total charge were significantly higher in HSCT with AKI, averaging 10 days and $168,313, respectively, compared to those without AKI, who had an average of 6 days and $117,117 (p-value = 0.00). The mortality rates for HSCT patients with AKI were 10.07%, compared to 2.42% for those without, with a p-value of 0.00. The gender disparities were noted in HSCT with AKI, with 62% affecting males and 38% affecting females.. There were no statistically significant epidemiological disparities in the patient population seeking care in hospital sizes, region, insurance status, and median income of the patient population, with p-value >0.05. Among the HSCT patients with AKI hospital admission, only 49.56% were discharged home. In contrast, 68.79% of patients who underwent HSCT without AKI were discharged home. Additionally, 14.51% of these patients required a skilled nursing facility, and 21% needed home health services. In comparison, among patients with HSCT without AKI, only 7.26% required a skilled nursing facility and 16.91% required home health services.

Conclusion

Our analysis revealed a significant health burden with increased total charges and mean length of stay, and also noted significant mortality differences between HSCT with and without AKI. This necessitates more aggressive treatment in patients with HSCT who have AKI

Digital Object Identifier (DOI)