Kidney Week

Abstract: FR-PO059

AKI Associated with Intestinal Ostomies

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

• Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Jonathan Chavez, PhD

• Hernandez Morales, Karla, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Karla Hernandez Morales, MD

• Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Guillermo Garcia-Garcia, MD, FASN

• Medina, Ramon, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Ramon Medina, MD

• Camacho, Jahir Ricardo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Jahir Ricardo Camacho, MD

• Carmona, Edgar Joel, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Edgar Joel Carmona, MD

• Oseguera Gonzalez, Alexa Nicole, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Alexa Nicole Oseguera Gonzalez, MD

• Murguía Soto, César, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

César Murguía Soto, MD

• Martínez Gallardo González, Alejandro, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico

Alejandro Martínez Gallardo González

Background

People with ostomies can have high output and be complicated by acute kidney injury (AKI). The clinical description of these patients and their association with the composite of major adverse kidney events (MAKE) has not been explored in depth.

Methods

In a retrospective cohort conducted at the Hospital Civil of Guadalajara Fray Antonio Alcalde. We included patients with AKI associated with ostomies (Ostomy-AKI) and compared them with AKI of other etiologies (General-AKI), with the objectives of describing and differentiating their clinical presentation and their association with early MAKE (MAKE10) and after 30 -90 days (MAKE 30-90), in addition to its individual components as death, new requirement for dialysis, or ≥25% decline in the eGFR from baseline. Analyzed the risk by logistic regression model and a multivariate Cox proportional hazard.

Results

During the period from February 2020 to October 2023, 84 patients in Ostomy-AKI were included and compared with 348 in General-AKI . The total cohort is composed mostly of men (59.3%), with an mean age of 55 years (41-67). In AKI-Ostomy patients were largely males (78.7 vs 56.2%), the output through the ostomy was 980 ml /day (760-1700), 82.9% required fluid adjustment; the cause of the ostomy was cancer in 46% and they had an average of 2.3 months with it. The etiology of AKI frequently due to hypovolemia (48.9 vs 24.5%) and they had more frequently AKI KDIGO stage 3 (82.9 vs 63.9%). Both groups had the same frequency of MAKE10 (94%), as were its individual components. The MAKE30-90 occurred more frequently in Ostomy-AKI (65.9 vs 49.3%), increasing more than two-fold the risk (OR 2.459, CI 1.134-5.332, p = 0.023), and it was very similar to its individual component of death (59.5 vs 37% ) (OR 2.678, CI 1.260-5.689, p = 0.010).

Conclusion

In comparison with General-AKI , patients with Ostomy-AKI present with more hypovolemia and higher mortality during the 30-90 day follow-up , and a 2.5-fold increase risk of MAKE, especially that of mortality.