Kidney Week

Abstract: TH-PO0759

Effect of AKI on Mortality and 30-Day Readmissions in Patients Hospitalized with Multiple Myeloma

Session Information

• AKI: Critical Care, CKRT, Cardiorenal Syndromes, and Clinical Outcomes
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Hirani, Chetna N., Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Chetna N. Hirani, MD

• Shah, Rushi, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Rushi Shah, MD, MBBS

• Bhatt, Parjanya K., Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Parjanya K. Bhatt, MBBS

• Muneeb, Muhammad, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Muhammad Muneeb, MD, MBBS

• Leslie, Merfilius, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Merfilius Leslie, MD

• Hanna, James, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

James Hanna, MD

Background

Acute kidney injury (AKI) is a common complication in patients with multiple myeloma and may significantly influence clinical outcomes. This study evaluated the association of AKI, including dialysis-requiring AKI, with in-hospital mortality and 30-day readmission.

Methods

We conducted a retrospective cohort study using the Nationwide Readmissions Database, including adult hospitalizations for multiple myeloma without end-stage renal disease. Patients were categorized into no AKI, AKI without dialysis, and AKI requiring dialysis. The primary outcome was 30-day readmission; secondary outcomes included in-hospital mortality. Multivariable Cox and logistic regression models were used to adjust for demographic, clinical, and hospital-level factors.

Results

Among 73,070 weighted index hospitalizations, 37.5% had AKI without dialysis and 2.2% required dialysis. Patients with AKI had higher comorbidity burden and complication rates, including sepsis and need for mechanical ventilation. In-hospital mortality increased markedly with AKI severity (2.7% no AKI vs. 9.1% AKI without dialysis vs. 25.4% AKI with dialysis; p<0.001). Similarly, 30-day readmission rates were higher in AKI groups (18.2% vs. 22.7% vs. 27.7%; p<0.001). After adjustment, AKI without dialysis (HR 1.22, 95% CI 1.16–1.29) and AKI with dialysis (HR 1.46, 95% CI 1.24–1.73) were independently associated with increased readmission risk. AKI was also a strong independent predictor of in-hospital mortality (OR 1.86 without dialysis; OR 2.68 with dialysis). Additional predictors of readmission included anemia requiring transfusion, heart failure, and higher comorbidity burden, while palliative care was associated with reduced readmission risk.

Conclusion

AKI, particularly when requiring dialysis, is strongly associated with increased mortality and 30-day readmissions in patients hospitalized with multiple myeloma. These findings highlight the need for early identification and targeted management strategies to mitigate AKI-related adverse outcomes.