Temporal trends of dialysis requiring acute kidney injury after orthotopic cardiac and liver transplant hospitalizations

BMC Nephrology

Research Article

Sunil Kamat¹  Madhav C. Menon²  Rocco Ferrandino²  Achint Patel²  Aparna Saha²  Girish N. Nadkarni²  Kinsuk Chauhan²  Priti Poojary²  Shanti Patel²  Ioannis Konstantinidis²  Pranav S. Garimella³  Charuhas V. Thakar⁴ 

[1] Division of Critical Care, Department of Medicine, Sir H.N. Reliance Hospital and Research Center, Mumbai, India;Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA;Division of Nephrology, Department of Medicine, University of California San Diego, San Diego, CA, USA;Division of Nephrology, Kidney CARE Program, University of Cincinnati, Cincinnati, USA;Renal Section, Cincinnati VA Medical Center, Cincinnati, OH, USA;Division of Nephrology and Hypertension, ML 0585, 231 Albert B Sabin Way, 45267, Cincinnati, OH, USA;

关键词: Acute kidney injury;    Cardiac transplant;    Liver transplant;    Mortality;    Outcomes;   

DOI  :  10.1186/s12882-017-0657-8

 received in 2017-02-15, accepted in 2017-07-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe epidemiology and outcomes of acute kidney injury (AKI) in prevalent non-renal solid organ transplant recipients is unknown.MethodsWe assessed the epidemiology of trends in acute kidney injury (AKI) in orthotopic cardiac and liver transplant recipients in the United States. We used the Nationwide Inpatient Sample to evaluate the yearly incidence trends (2002 to 2013) of the primary outcome, defined as AKI requiring dialysis (AKI-D) in hospitalizations after cardiac and liver transplantation. We also evaluated the trend and impact of AKI-D on hospital mortality and adverse discharge using adjusted odds ratios (aOR).ResultsThe proportion of hospitalizations with AKI (9.7 to 32.7% in cardiac and 8.5 to 28.1% in liver transplant hospitalizations; ptrend<0.01) and AKI-D (1.63 to 2.33% in cardiac and 1.32 to 2.65% in liver transplant hospitalizations; ptrend<0.01) increased from 2002-2013. This increase in AKI-D was explained by changes in race and increase in age and comorbidity burden of transplant hospitalizations. AKI-D was associated with increased odds of in hospital mortality (aOR 2.85; 95% CI 2.11-3.80 in cardiac and aOR 2.00; 95% CI 1.55-2.59 in liver transplant hospitalizations) and adverse discharge [discharge other than home] (aOR 1.97; 95% CI 1.53-2.55 in cardiac and 1.91; 95% CI 1.57-2.30 in liver transplant hospitalizations).ConclusionsThis study highlights the growing burden of AKI-D in non-renal solid organ transplant recipients and its devastating impact, and emphasizes the need to develop strategies to reduce the risk of AKI to improve health outcomes.

【 授权许可】

CC BY   
© The Author(s). 2017