Kidney Week

Abstract: TH-PO0760

AKI and In-Hospital Outcomes Among Patients Hospitalized with Acute Right Heart Failure and Pulmonary Embolism: A National Inpatient Analysis

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

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

Parjanya K. Bhatt, MBBS

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

Chetna N. Hirani, MD

• Vora, Tanisha, Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Tanisha Vora, MD

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

Rushi Shah, MD, MBBS

• Urhoghide, Eseosa Omosivie, Authority Health, Detroit, Michigan, United States

Eseosa Omosivie Urhoghide, MD

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

Muhammad Muneeb, MD, MBBS

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

James Hanna, MD

Background

Acute right heart failure (RHF) secondary to pulmonary embolism (PE) is associated with high morbidity, hemodynamic instability, and multiorgan dysfunction. Acute kidney injury (AKI) is frequently encountered in this population, but its prognostic significance remains poorly defined. We evaluated the impact of AKI on mortality and healthcare utilization among patients hospitalized with acute RHF and PE.

Methods

We performed a retrospective cohort study using the 2021–2023 National Inpatient Sample (NIS). Adult hospitalizations with acute PE and concomitant RHF were identified using ICD-10-CM codes and stratified by AKI status. Patients with end-stage renal disease were excluded. Survey-weighted analyses generated national estimates. Baseline characteristics and outcomes were compared using design-based testing. Survey-weighted multivariable logistic regression identified independent predictors of in-hospital mortality.

Results

A weighted total of 8,495 hospitalizations with acute RHF and PE were identified; 44.2% had AKI. AKI had fewer common females (45.9% vs 53.6%), and blacks were more prevalent (24.3% vs 17.9%). Patients with AKI had higher rates of cardiogenic shock (29.4% vs 10.0%), sepsis (26.0% vs 8.2%), septic shock (16.6% vs 2.5%), mechanical ventilation (34.5% vs 10.6%), and ICU admission (54.3% vs 20.5%) (all p<0.001). In-hospital mortality was significantly higher in AKI patients (27.4% vs 9.5%). AKI was associated with longer length of stay (11.1 vs 8.0 days), higher hospital charges ($237,421 vs $153,435), lower routine home discharge (37.8% vs 54.1%), and greater need for facility transfer or rehabilitation care. On multivariable analysis, AKI remained independently associated with higher in-hospital mortality (aOR 1.68, 95% CI 1.09–2.60, p=0.019). Mechanical ventilation (aOR 4.9, p<0.001), ICU-level care (aOR 4.9, p<0.001), and increasing age (aOR 1.03/year, p=0.001) were independent predictors of mortality.

Conclusion

Among patients hospitalized with acute RHF and PE, AKI was common and independently associated with higher in-hospital mortality, prolonged hospitalization, and increased healthcare utilization. These findings identify AKI as an important marker of clinical deterioration in the high-risk population and highlight the need for early renal risk stratification and aggressive multidisciplinary management.