Kidney Week

Abstract: FR-PO028

More Hospitalized Pregnant Women in the United States Are Dying with AKI

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Fwu, Chyng-Wen, Social and Scientific Systems, Inc., a DLH Holdings Corp (DLH) company, Silver Spring, Maryland, United States

Chyng-Wen Fwu, DrPH

• Mendley, Susan R., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Susan R. Mendley, MD

• Maric-Bilkan, Christine, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Christine Maric-Bilkan, PhD, FASN

• Givens-Bradley, Shannon Sharee, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Shannon Sharee Givens-Bradley, DHSc, MPH

• Kimmel, Paul L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Paul L. Kimmel, MD, FASN

• Greer, Raquel C., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Raquel C. Greer, MD

• Chan, Kevin L., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Kevin L. Chan, MD, MS, MSc

• Wilkins, Kenneth J., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Kenneth J. Wilkins, PhD

• Schulman, Ivonne Hernandez, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Ivonne Hernandez Schulman, MD, MA, FASN

Background

Recent national trends for death occurring in hospitalized pregnant women who have acute kidney injury (AKI) have not been reported. Increased delivery-related hospitalizations with AKI were reported between 2006-2015 but did not include all pregnancy-related hospitalizations.

Methods

The 2019-2021 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) was analyzed to 1) describe the in-hospital rate of AKI, as primary or secondary diagnosis, and death; 2) evaluate associations of all-cause death with AKI after adjustment of pre-defined predictors; and 3) estimate the number needed to harm (NNH), a death due to AKI, in women ages 12-49 years with pregnancy-related hospitalizations, including delivery or non-delivery, and excluding hospitalizations with end-stage renal disease diagnosis. ICD-10-CM codes and/or the Clinical Classifications Software Refined diagnostic categories were used. Mortality trend and association between in-hospital AKI diagnosis and death were examined using multivariate logistic regression.

Results

Table shows the number of pregnancy hospitalizations recorded in the HCUP-NIS during 2019-2021, the increased rate of in-hospital AKI and death, and the increased number and rate of deaths among hospitalizations with AKI. AKI was one of the major comorbid conditions in pregnant women who died (40%). Deaths with AKI as a percentage of total deaths increased from 35% to 41%. Overall mortality difference between hospitalizations with and without AKI was 2.52%. The NNH with AKI was 40. Adjusted for age, race/ethnicity, CVD, cancer, infection, hemorrhage, and pregnancy-related complications, the odds of death increased annually by 40% per year (Adjusted Odds Ratio (AOR), 1.40; 95% confidence interval (CI), 1.23 to 1.60). AKI was significantly associated with death (AOR 26.33, 95% CI 20.61 to 33.65).

Conclusion

From 2019-2021, increased numbers of hospitalized pregnant women died with AKI. Additionally, deaths with AKI are increasing faster than total deaths.

Funding

• NIDDK Support