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Abstract: SA-PO084

Association of Black Race, Diabetes, and Obesity with AKI During Hospitalization in a Large Multicenter US Cohort

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Takeuchi, Tomonori, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Ghazi, Lama, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Moe, Orson W., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Toto, Robert D., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Rahman, Akm Fazlur, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Siew, Edward D., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Gutierrez, Orlando M., The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

AKI is a common complication during hospitalization that is associated with morbidity and mortality. Whereas multiple studies have identified risk factors for the development of AKI in hospitalized patients, few have examined risk factors for the severity of AKI, including non-recovery of AKI.

Methods

Multicenter retrospective cohort study of patients ≥18 years old without ESKD or kidney transplant who were admitted to the hospital from 10/2014 to 9/2017. Data were extracted from electronic health records of 3 large academic medical centers. Study outcomes included (1) incidence and severity of AKI and (2) non-recovery from AKI in those who survived the hospitalization. AKI was defined by KDIGO SCr-criteria, using all inpatient SCr data available and the lowest value of the first three inpatient measurements as the baseline. Non-AKI recovery was defined in hospital survivors as persistent AKI stage ≥1 using the last SCr during the hospitalization or if the patient received dialysis within 72h of hospital discharge. We used multivariable logistic regression models to evaluate the association of black race, diabetes and obesity (BMI ≥30 vs. <30 kg/m2) with the outcomes, and each of the models was adjusted for 2 other of these main factors, and covariates such as study site, age, sex, baseline eGFR, and Elixhauser comorbidity score.

Results

Among 56,056 patients included in the study, 12,954 (23%) developed AKI during hospitalization. In adjusted models, black race (OR 1.26, 95%CI 1.20-1.32), diabetes (OR 1.14, 95%CI 1.08-1.19) and obesity (OR 1.14, 95%CI 1.10-1.20) were all associated with incident AKI, though only obesity was associated with AKI stage 2 or 3. Only obesity was associated with non-recovery from AKI at hospital discharge (OR 1.27, 95%CI 1.17-1.39).

Conclusion

Black race, diabetes and obesity were associated with incident hospitalized AKI, but only obesity was associated with moderate to severe AKI and non-recovery from AKI at hospital discharge. Obesity may help identify individuals at highest risk for severe AKI and those survivors requiring close follow-up after discharge.