Abstract: TH-PO059
Trends and Racial and Geographic Disparities in AKI-Related Mortality Rate in the United States, 1999-2019
Session Information
- AKI: Clinical, Outcomes, and Trials - Epidemiology and Pathophysiology
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Ayirebi-Acquah, Ewuradjoa, Lekma Hospital, Accra, Ghana
- Frimpong, Zaneta, University of Ghana Medical Centre, Accra, Accra, Ghana
- F. Gyamfi, Abena A., Ridge Medical Center, Accra, Ghana
- Addo-Quaye, Nii A. A., Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
- Oppong-Twum, Sandra, Korle Bu Teaching Hospital, Accra, Greater Accra, Ghana
- Nyamikeh, Stella, 37 Military Hospital, Accra, Ghana
- Prempeh, Isaac, New Hope Specialist Hospital, Aflao, Ghana
Background
Acute kidney injury (AKI) is associated with increased risk of death. However, previous studies before 2010 showed conflicting trends in AKI-related mortality rate (AKI-MR) in the United States (US). Also,little is known about racial disparities in AKI-MR. We examined the trends and racial disparities in AKI-MR in adults in the US from 1999 to 2019.
Methods
This was a retrospective cross-sectional analysis of national death certificate data from the CDC’s Wide-ranging Online Database for Epidemiological Research from 1999-2019. We used ICD-10 codes N17 and O90.4 to identify adults >18 years old whose death certificates mentioned AKI as a cause of death. The exposure variables were calendar year, race, and geographic region. The outcome variable was the crude AKI-MR which was calculated per 100,000 population. The Mann-Whitney U test and ANOVA were used to compare groups and P<0.05 defined statistical significance. We evaluated temporal trends with Joinpoint regression, which was expressed as average annual percentage change (AAPC) with 95% confidence intervals (CI).
Results
There were 1,093,865 AKI-related deaths out of a population of 4,784,988,012 [overall crude AKI-MR 22.9 per 100,000 (95% Cl, 22.8-22.9). The AKI-MR was higher in males (24 vs 21.7 in females; P=0.03), non-Hispanic White (NHW) [26.1 vs 23.8 in non-Hispanic Black (NHB), P=0.04], rural areas (30.3 vs 21.5 in urban areas; P<0.001), and the Midwest (24.8). From 1999-2019, the overall crude AKI-MR increased from 15.3 to 24.6 (AAPC 2.4%; CI: 2.3-2.6). The AKI-MR increased for males (AAPC 2.6%; CI: 2.5-2.8), females (AAPC 2.3%, CI: 2.2-2.5), NHB (AAPC 1.6, CI: 1.4-1.8), NHW (AAPC 2.8%, CI: 2.7-2.9), urban areas (AAPC 2.4%, CI: 2.2-2.5), rural areas (AAPC 3.3%, CI: 3.1-3.6), and across all census regions. When limited to AKI as the underlying cause of death, the crude AKI-MR increased overall, and for all genders, racial groups, urban and rural areas, and all census regions.
Conclusion
The AKI-MR increased significantly in the US from 1999-2019 and it varied by race, sex, and geographic region. These underscore the public health importance of AKI as a significant contributor to mortality in adults and it is an opportunity for further studies into the optimization of the care of patients with AKI.