Changes in acute kidney injury epidemiology in critically ill patients: a population-based cohort study in Korea

Subin Hwang, Hyejeong Park, Youngha Kim, Danbee Kang, Ho Suk Ku, Juhee Cho, Jung Eun Lee, Wooseong Huh, Eliseo Guallar, Gee Young Suh, Hye Ryoun Jang

Research output: Contribution to journalArticle

Abstract

Background: Although no specific treatment facilitates renal tubular regeneration in acute kidney injury (AKI), the rapid increase in aging populations with more comorbidities and advances in critical care management are expected to change the epidemiology of AKI. However, few recent studies dissected the current epidemiologic characteristics of critically ill patients with AKI. We investigated recent epidemiologic changes in severe AKI in critically ill patients. Methods: All adult admissions to intensive care units (ICUs) in Korea from 2008 to 2015 were screened using the national health insurance review and assessment database, and 1,744,235 patients were included. Clinical characteristics and changes in AKI incidence and mortality rate were analyzed. Results: The incidence of AKI increased from 7.4% in 2008 to 8.3% in 2015 (p for trend < 0.001). Age-standardized AKI rate was 7018.6 per 100,000 person-years. In-hospital mortality significantly decreased from 39.1% in 2008 to 37.2% in 2015 (p for trend < 0.001) with 2427.6 deaths per 100,000 person-years. Patients with AKI showed higher in-hospital mortality, prolonged ICU length of stay, and higher total cost. Multivariable analysis showed increased risk of in-hospital mortality (adjusted odds ratio [OR] 3.74), mechanical ventilation (OR 2.87), ECMO (OR 6.99), and vasopressor requirement (OR 2.75) in patients with AKI. Conclusions: Recent advances in medical management for AKI have improved in-hospital mortality of critically ill patients with AKI despite increases in the elderly population and AKI incidence.

Original languageEnglish (US)
Article number65
JournalAnnals of Intensive Care
Volume9
Issue number1
DOIs
StatePublished - Dec 1 2019

Keywords

  • Acute kidney injury
  • Critically ill patients
  • Intensive care unit
  • Mortality

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Hwang, S., Park, H., Kim, Y., Kang, D., Ku, H. S., Cho, J., Lee, J. E., Huh, W., Guallar, E., Suh, G. Y., & Jang, H. R. (2019). Changes in acute kidney injury epidemiology in critically ill patients: a population-based cohort study in Korea. Annals of Intensive Care, 9(1), [65]. https://doi.org/10.1186/s13613-019-0534-7