Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction

Amit P. Amin, Adam C. Salisbury, Peter A. McCullough, Kensey Gosch, John A. Spertus, Lakshmi Venkitachalam, Joshua M. Stolker, Chirag Parikh, Frederick A. Masoudi, Phillip G. Jones, Mikhail Kosiborod

Research output: Contribution to journalArticle

Abstract

Background: Acute kidney injury (AKI) is common in patients with acute myocardial infarction (AMI) and is associated with permanent renal impairment and death. Although guidelines increasingly emphasize AKI prevention, whether increased awareness has translated into reduced AKI rates is unclear. Methods: Among 33 249 consecutive hospitalizations in 31 532 unselected patients with AMI across 56 US centers from Cerner Corporation's HealthFacts database, we examined the temporal trends in AKI incidence from 2000 to 2008. Acute kidney injury was defined as an absolute increase in creatinine level of at least 0.3 mg/dL or a relative increase of at least 50% during hospitalization. Results: From 2000 to 2008, the mean age of patients increased (from 66.5 to 68.6 years), as did the known AKI risk factors, including chronic kidney disease, cardiogenic shock, diabetes mellitus, heart failure, coronary angiography, and percutaneous coronary intervention. Despite this, AKI incidence declined from 26.6% in 2000 to 19.7% in 2008 (P<.001). After multivariate adjustment, the trend of decreasing AKI rates persisted (4.4% decline per year; P<.001). In addition, inhospital mortality also declined over time among patients developing AKI, from 19.9% in 2000 to 13.8% in 2008 (P=.003). Conclusions: In a large national study, AKI incidence in patients hospitalized with AMI declined significantly from 2000 to 2008 despite the aging population and rising prevalence of AKI risk factors. These findings may reflect increased clinician awareness, better risk stratification, or greater use of AKI prevention efforts during this time period.

Original languageEnglish (US)
Pages (from-to)246-253
Number of pages8
JournalArchives of Internal Medicine
Volume172
Issue number3
DOIs
StatePublished - Feb 13 2012

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Acute Kidney Injury
Myocardial Infarction
Incidence
Hospitalization
Cardiogenic Shock
Percutaneous Coronary Intervention
Hospital Mortality
Coronary Angiography
Chronic Renal Insufficiency
Creatinine
Diabetes Mellitus
Heart Failure
Databases
Guidelines
Kidney

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Amin, A. P., Salisbury, A. C., McCullough, P. A., Gosch, K., Spertus, J. A., Venkitachalam, L., ... Kosiborod, M. (2012). Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. Archives of Internal Medicine, 172(3), 246-253. https://doi.org/10.1001/archinternmed.2011.1202

Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. / Amin, Amit P.; Salisbury, Adam C.; McCullough, Peter A.; Gosch, Kensey; Spertus, John A.; Venkitachalam, Lakshmi; Stolker, Joshua M.; Parikh, Chirag; Masoudi, Frederick A.; Jones, Phillip G.; Kosiborod, Mikhail.

In: Archives of Internal Medicine, Vol. 172, No. 3, 13.02.2012, p. 246-253.

Research output: Contribution to journalArticle

Amin, AP, Salisbury, AC, McCullough, PA, Gosch, K, Spertus, JA, Venkitachalam, L, Stolker, JM, Parikh, C, Masoudi, FA, Jones, PG & Kosiborod, M 2012, 'Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction', Archives of Internal Medicine, vol. 172, no. 3, pp. 246-253. https://doi.org/10.1001/archinternmed.2011.1202
Amin, Amit P. ; Salisbury, Adam C. ; McCullough, Peter A. ; Gosch, Kensey ; Spertus, John A. ; Venkitachalam, Lakshmi ; Stolker, Joshua M. ; Parikh, Chirag ; Masoudi, Frederick A. ; Jones, Phillip G. ; Kosiborod, Mikhail. / Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. In: Archives of Internal Medicine. 2012 ; Vol. 172, No. 3. pp. 246-253.
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