Kidney Week

Abstract: FR-PO085

AKI Outcomes among Hospitalized Patients with Acute Myeloid Leukemia and Sepsis

Session Information

• AKI: Diagnosis and Outcomes
  October 25, 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

• Nangia, Udit, UH Parma Medical Center, Parma, Ohio, United States

Udit Nangia, MD

• Simhadri, Prathap, AdventHealth East Florida, Daytona Beach, Florida, United States

Prathap Simhadri, MD, MPH, FASN

• Takeuchi, Tomonori, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Tomonori Takeuchi, MD

• Garapati, Hari Naga, Baptist Medical Center South, Montgomery, Alabama, United States

Hari Naga Garapati, MD, MPH

• Avula, Sreekant, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Sreekant Avula, MD

• Jena, Nihar K., Trinity Health Oakland Hospital, Pontiac, Michigan, United States

Nihar K. Jena, MD

• Patel, Devansh H., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Devansh H. Patel, MBBS, MD

• Singh, Prabhat, Christus Spohn Health System, Corpus Christi, Texas, United States

Prabhat Singh, MD

• Chandramohan, Deepak, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Deepak Chandramohan, MD, FASN

Background

Sepsis in patients with Acute Myeloid leukemia (AML) is a common cause of Acute kidney injury (AKI). Data on the outcomes of these patients is lacking.

Methods

We queried the 2016-2020 National Inpatient Sample (NIS) database to collect data on hospitalized adults with sepsis and AML. A multivariable logistic regression was performed while adjusting for potential confounders to generate adjusted odds ratios for the outcomes of interest. The outcomes assessed were inpatient mortality, length of stay (LOS), total hospital charges, fluid and electrolyte disorders, septic shock, vasopressor support, and the requirement for mechanical ventilation.

Results

Out of 288,435 hospital admissions of patients with sepsis and AML, 61,955 (21.4%) had AKI. Patients with AKI were older (mean age 66.1 vs. 60.4 years), more likely to be males (63.1% vs. 52.8%), more blacks were affected (12% vs. 9.2%) and overall had more comorbidities. Tumor lysis syndrome was present in 11.1%. Compared to patients without AKI, patients with AKI had higher LOS days (15.4±18 vs. 10.8±13.1, p<0.001 and hospital charges (229425.2 $ vs. 134930.3 $, p<0.001). Multivariable analysis showed that the patients with AKI had higher odds of mortality (OR: 3.8, 95% CI: 3.6-4.1, p<0.001). They also had a higher risk for electrolyte disorders (OR: 2.2, 95% CI: 2.1-2.4, p<0.001), septic shock (OR: 6.3, 95% CI: 5.7-6.9, p<0.001), vasopressor requirement (OR: 5, 95% CI: 4.3-5.8, p<0.001) and mechanical ventilation (OR: 5.2, 95% CI: 4.7-5.7, p<0.001).

Conclusion

AKI in patients with sepsis and AML was associated with higher mortality than sepsis alone. Further large studies are required to identify factors that could improve outcomes.