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2015 ; 29
(9
): 1061-6
Nephropedia Template TP
gab.com Text
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English Wikipedia
The burden of dialysis-requiring acute kidney injury among hospitalized adults
with HIV infection: a nationwide inpatient sample analysis
#MMPMID26125139
Nadkarni GN
; Patel AA
; Yacoub R
; Benjo AM
; Konstantinidis I
; Annapureddy N
; Agarwal SK
; Simoes PK
; Kamat S
; Menon MC
; Wyatt CM
AIDS
2015[Jun]; 29
(9
): 1061-6
PMID26125139
show ga
OBJECTIVE: The objective of this study was to describe the incidence of acute
kidney injury (AKI) requiring renal replacement therapy ('dialysis-requiring
AKI') and the impact on in-hospital mortality among hospitalized adults with HIV
infection. DESIGN: A longitudinal analysis of a nationally representative
administrative database. METHODS: We reviewed the Healthcare Cost and Utilization
Project's Nationwide Inpatient Sample Database, a large, nationally
representative sample of inpatient hospital admissions, to identify all adult
hospitalizations with an associated diagnosis of HIV infection from 2002 to 2010.
We analysed temporal trends in the incidence of dialysis-requiring AKI and the
associated odds of in-hospital mortality. We also explored potential reasons
behind temporal changes. RESULTS: Among 183 0041 hospitalizations with an
associated diagnosis of HIV infection, the proportion complicated by
dialysis-requiring AKI increased from 0.7% in 2002 to 1.35% in 2010. This
temporal rise was completely explained by changes in demographics and an increase
in concurrent comorbidities and procedure utilization. The adjusted odds of
in-hospital mortality associated with dialysis-requiring AKI also increased over
the study period, from 1.45 [95% confidence interval (95% CI) 0.97-2.12] in 2002
to 2.64 (95% CI 2.04-3.42) in 2010. CONCLUSION: These data suggest that the
incidence of dialysis-requiring AKI among hospitalized adults with HIV infection
continues to increase, and that severe AKI remains a significant predictor of
in-hospital mortality in this population. The increased incidence of
dialysis-requiring AKI was largely explained by ageing of the HIV population and
increasing prevalence of chronic non-AIDS comorbidities, suggesting that these
trends will continue.